Why the study?
Paroxysmal supraventricular tachycardia is a common arrhythmia that frequently presents with symptoms resembling acute coronary syndrome.
This case highlights that significant high-sensitivity troponin elevation during paroxysmal supraventricular tachycardia can occur in the absence of obstructive coronary artery disease, likely due to demand ischemia.
Kontext: ParoxysmĂĄlnĂ supraventrikulĂĄrnĂ tachykardie (PSVT) je bÄĹžnou formou arytmie, kterĂĄ se Äasto projevuje symptomy pĹipomĂnajĂcĂmi akutnĂ koronĂĄrnĂ syndrom (AKS). Popis pĹĂpadu: Popisujeme pĹĂpad 58letĂŠho muĹže s PSVT doprovĂĄzenou bolestĂ na hrudi a zvýťenĂ˝mi hodnotami troponinu namÄĹenĂ˝mi vysoce senzitivnĂ metodou (high-sensitivity troponin, hs-Tn). KoronarografickĂŠ vyĹĄetĹenĂ prokĂĄzalo pomalĂ˝ prĹŻtok krve koronĂĄrnĂmi tepnami v nepĹĂtomnosti obstrukÄnĂho postiĹženĂ. Pa- cientovy symptomy vymizely spontĂĄnnÄ a echokardiografickĂŠ parametry mÄly pĹi jeho propouĹĄtÄnĂ normĂĄlnĂ hodnoty. ZĂĄvÄry: PopisovanĂ˝ pĹĂpad ukazuje diagnostickou nĂĄroÄnost rozpoznĂĄvĂĄnĂ AKS a upozorĹuje na pĹechodnĂŠ zvýťenĂ hodnot troponinu pĹi PSVT, moĹžnĂĄ v dĹŻsledku ischemie myokardu na podkladÄ rychlĂŠ srdeÄnĂ frekvence. PĹi rozhodovĂĄnĂ o lĂŠÄbÄ, zvlĂĄĹĄtÄ v nepĹĂtomnosti vĂ˝znamnĂŠ ischemickĂŠ choroby, je nezbytnĂŠ opĹĂt se o klinickĂŠ korelace a pouĹžĂt doplĹkovĂŠ diagnostickĂŠ metody.
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Miccichè et al. (2025) studied this question.
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