Article: CAR-4. Chest pain and increased Troponin: acute coronary syndrome?(Section on Cardiology)

A 31-year-old male with past medical history of infective endocarditis and aortic valve replacement presented from an outside hospital with chest pain for 1 day, EKG changes and rise in his cardiac enzymes. He presented there with sharp chest pain, refractory to sublingual nitroglycerin and intravenous Dilaudid and difficulty breathing. EKG showed T wave inversions inferolaterally. His second set of Troponin-I was positive. He was transferred to our hospital for further management. On exam, a systolic murmur was noted. His Troponin-T at our hospital was elevated at 0.5. Transesophageal echocardiogram showed possible evidence of myocardial infarction with wall motion ...

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