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Vojnosanitetski pregled
2012, vol. 69, br. 10, str. 913-916
jezik rada: engleski
vrsta rada: prikaz slučaja
objavljeno: 16/10/2012
doi: 10.2298/VSP1210913V
Određivanje vrednosti troponina pri diferencijalnom dijagnostikovanju bola u grudima sa stanovišta pulmonarne tromboembolije
aKlinički centar Kragujevac, Klinika za kardiologiju
bKlinički centar Kragujevac, Klinika za internu medicinu
cKlinički centar Kragujevac, Klinika za pulmologiju
dUniverzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd

Sažetak

Uvod. Akutni koronarni sindrom, kao nestabilni oblik ishemijske bolesti srca, pored kliničke slike i elektrokardiografskih promena, karakteriše i porast vrednosti jednog od kardiospecifičnih enzima - troponina. Ipak, bez obzira na to što je troponin visokospecifičan i senzitivan indikator akutnog koronarnog sindroma, svako oštećenje srčanog mišića može dovesti do njegovog porasta, pa postoji određen broj drugih bolesti gde se posledično javljaju povišene vrednosti troponina u perifernoj krvi. Prikaz bolesnika. Prikazana je bolesnica hospitalizovana zbog bolova u grudima i sumnje na akutni koronarni sindrom. Urađena je koronarografija kojom je isključeno postojanje ishemijske bolesti srca. S obzirom na simptomatologiju, promene u EKG-u, pozitivne vrednosti troponina i D-dimera, kao i ehokardiografski nalaz, diferencijalno dijagnostički razmatrana plućna embolija, koja je dokazana pulmoangiografijom. Zaključak. Povišene vrednosti srčanog troponina ne mogu izolovano obezbediti dijagnozu akutnog koronarnog sindroma.

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Reference

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