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 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A dry chemistry system for rapid qualitative measurement of cardiac troponin T in whole blood, serum, EDTA and lithium heparin plasma was studied in 197 admissions to the coronary care unit and general wards of a typical district general hospital for whom troponin T was requested. This included patients with unexplained collapse, acute dysrythmia or elevated creatine kinase of unknown origin. EDTA whole blood and plasma proved the most satisfactory sample matrices. Lithium heparin whole blood was equally appropriate but lithium heparin plasma gave a false negative result. Serum was an unsatisfactory sample material. Comparison with the conventional wet chemistry quantitative enzyme-linked immunosorbent assay showed a positive bias for EDTA plasma, particularly in the range 0-1 microgram/L and a significant negative bias for lithium heparin plasma. There was no difference between serum from plain or gel separator tubes. The whole blood method allows troponin T measurement to be performed rapidly and simply in the laboratory, either as an emergency test to alter patient management, or for those laboratories that wish to offer troponin T for selected cases but do not have the ability to measure troponin T quantitatively.
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PMID:Rapid troponin T measurement in whole blood for detection of myocardial damage. 883 Jun 19

Ephedra, a herb reported to suppress appetite and stimulate the sympathetic nervous system as well as cardiac performance, has recently been related to several adverse events, including seizure, stroke, hypertension, myocardial infarction, and sudden death. Here, we describe the case of a 45-year-old woman who died of cardiovascular collapse while taking ephedra. Tissue analysis revealed non-specific degenerative alterations in the myocardium (lipofuscin accumulation, basophilic degeneration and vacuolation of myocytes, as well as myofibrillary loss), associated with myocyte apoptosis, caspase activation, and extensive cleavage of miofibrillary proteins alpha-actin, alpha-actinin, and cardiac troponin T. Healthcare professionals are therefore urged to warn their patients about the risk of serious adverse effects, which may follow ephedra intake.
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PMID:A case of fatal ephedra intake associated with lipofuscin accumulation, caspase activation and cleavage of myofibrillary proteins. 1605 66

We measured analytes in collapsed Boston Marathon runners to compare with changes in asymptomatic runners. Of collapsed runners at the 2007 marathon, 18.2% had a measurable cardiac troponin T (cTnT) value with a mean postrace level of 0.017 ng/mL (0.017 microg/L; SD, 0.02 ng/mL [0.02 microg/L]). Three subjects had cTnT values above the cutoff (0.10 ng/mL [0.10 microg/L]) typically used for the diagnosis of acute myocardial infarction. The mean and median N-terminal pro-B-type natriuretic peptide levels were 73 ng/L (SD, 77.3 ng/L) and 54.3 ng/L (interquartile range, 22.8-87.3 ng/L), respectively, in collapsed runners. Only 4.9% had values more than the age-specific normal value (<125 ng/L for subjects younger than 75 years). In collapsed subjects at the 2006 marathon, 18.0% had an abnormal sodium value, including 18 cases of hypernatremia and 7 cases of hyponatremia. The ionized calcium level was low in 49% of subjects, and the ionized magnesium level was low in 19.5% and elevated in 1 subject. The blood lactate level was elevated in 95% of subjects. The frequency of elevated postrace cTnT levels in collapsed athletes after endurance exercise is similar to that in asymptomatic runners. Other metabolic abnormalities, including hypernatremia, hyponatremia, low ionized calcium and magnesium levels, and lactic acidosis may contribute to muscle fatigue and collapse.
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PMID:Cardiac biomarkers, electrolytes, and other analytes in collapsed marathon runners: implications for the evaluation of runners following competition. 1848 12

Myocarditis is an inflammatory disease of the heart that can cause devastating disease in otherwise healthy children. Inciting agents such as viral infection cause direct damage to the myocardial cells, which triggers an inflammatory response that enhances myocardial toxicity and associated morbidity. Severe cases typically present with respiratory distress and cardiovascular collapse, whereas subclinical cases are unnoticed by the medical community. The initial workup in suspected cases should include an electrocardiogram, chest radiograph, and cardiac troponin T. Treatment is concentrated on hemodynamic stabilization with optimization of heart failure management, dysrhythmia protocol, and supportive therapy. The purpose of this review was to provide the emergency medicine practitioner a concise and current review of the basic pathophysiology as well as a functional and evidence-based approach to the diagnosis and treatment of myocarditis in the pediatric population.
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PMID:Myocarditis. 2537 72