How we must change treatment and diagnostic patients with ischemic stroke when we detect high level of troponin and didn*t see anything change on ECG?
Thank you. Our cardiologists consider that high troponin is not specific lab data for patients with ischemic stroke which go to endovascular treatment and it don*t need anything diagnostic researches (coronarography and may be stenting). If you have any experience and guide so you make could you sent me?
Diagnostic test..lipid profile.if diabetic Hb A1c. Carotid doppler..
Treatment...Aspirin. dipyridamole....or antiplatelet antilipid drugs... rest treat according to the report of diagnostic test
Follow the algorithm for N-STEMI. If you don not want to approach via invasive diagnostics use coronary CT on availability. If you suspect myocardial infarction cardiac-MRI with adenosine has a relative contraindication when conducted within 48h post suspected infarction for adenosine or dubutamine, as these stress the myocardium. However, without apllication of either it is a good tool to see myocardial vitality and changes in the tissue.
As Andrei said myocardial infarction does not have to display changes in ECG necessarily.
If you want to rule MI out, rule it out. Take the patients state, age and perspective into account. Plan ahead and together with patient and relatives.
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