Author: Dale Kirkwood / Editor: Fiona Mendes / Reviewer: Ciaran Mackle / Codes: / Published: 19/07/2019 / Reviewed: 19/08/2024
An 81-year-old male presents to the Emergency Department (ED) following a collapse and transient loss of consciousness after urinating. There was no significant trauma. He now feels much better and would like to go home. He also admitted to a few months of increasing fatigue and 8 kilograms of weight loss over the past four months. You encourage him to stay for further investigation.
Observations:
Heart rate: 101 beats per minute
Blood pressure: 104/64
Respiratory rate: 18 per minute
Saturations: 100% in room air
Temperature: 37.1oC
A troponin level was included in the initial triage panel of blood tests. Troponin level is 138 (normal range <14ng/L). He did not have chest pain. He is pain-free on review.
His ECG has a new Q wave with T wave inversion in lead III. Treatment for non-ST-elevation myocardial infarction was initiated. The subsequent troponin level is 168.
