Key result
Cholecystectomy led to the normalization of spuriously elevated high-sensitive cardiac troponin I in a 15-year-old female presenting with acute cholecystitis.
Why the study?
Cardiac troponin I is the gold standard for diagnosing acute myocardial infarction, but it can also be elevated in non-AMI cardiac conditions and certain noncardiac conditions.
Case Report (n=1)
No
Acute cholecystitis can cause spurious elevation of high-sensitive cardiac troponin I mimicking acute myocardial infarction, which normalizes following cholecystectomy.
Acute cholecystitis may cause spurious hs-cTnI elevation; this single case leaves open generalizability and need for prospective validation.
Cardiac troponin I (cTnI) is regarded as a gold standard investigation for the diagnosis of acute myocardial infarction (AMI). However, cTnI may be elevated in certain non-AMI cardiac conditions and even in certain noncardiac conditions. We report a case of a young female presenting with symptoms suggestive of acute cholecystitis with elevated high-sensitive cardiac troponin I (hs-cTnI). The patient developed acute chest pain during the hospital stay. On evaluation, quantitative assay for hs-cTnI was found to be elevated; however, other markers of cardiac damage such as creatinine kinase-MB (CK-MB), qualitative cTnI by card test, and even echocardiogram (ECG) were found to be negative. As the patient was a young female with no significant history of coronary diseases, the spurious elevation of hs-TnI due to a noncardiac ailment was suspected. The patient was managed with minimal cardiological management till AMI was excluded. The hs-cTnI levels returned to normal post-cholecystectomy. A patient presenting with symptoms suggestive of cholecystitis and elevated hs-cTnI must be carefully evaluated before resorting to any invasive management for AMI. In most cases, hs-cTnI will return to normal post-cholecystectomy.
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Amle et al. (2022) conducted a case report in Acute cholecystitis (n=1). Cholecystectomy was evaluated on hs-cTnI levels. Cholecystectomy led to the normalization of spuriously elevated high-sensitive cardiac troponin I in a 15-year-old female presenting with acute cholecystitis.
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