The Internet Book of Critical Care Podcast IBCC Episode 2 - Ischemic Evaluation in the Non-Cardiac Patient
21 snips
Sep 12, 2018 AI Snips
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Episode notes
Avoid Reflexive Troponin Testing
- Avoid reflexively ordering troponin tests for all ICU patients.
- This leads to false positives and unnecessary interventions like angiography, causing harm.
Targeted Troponin Testing
- Order troponin tests only when genuinely concerned about myocardial infarction (MI) based on patient history, ECG, and echo.
- Use a positive troponin result as a trigger to reconsider the MI diagnosis.
Defining Myocardial Infarction
- Myocardial infarction (MI) is defined by a dynamic rise and fall in troponin and one of three factors: concerning clinical history, new ECG changes, or new wall motion abnormality on echo.
- An isolated positive troponin, common in critically ill patients due to stress, doesn't qualify as an MI.