Discover and read the best of Twitter Threads about #troponin

Most recents (5)

After a 4-day tour of duty here are some pearls:
#COVIDPearl 1: PE and thrombosis are common. Have a low threshold to treat with full dose Lovenox when Ddimers are markedly elevated and you are having difficulty weaning O2, or there is a setback in the patient’s O2 requirement
#COVIDPearl 2. Be prepared to see sky high inflammatory markers including #CRP and #Ferritin. Their magnitude is not as important as their trends.
#COVIDPearl 3: If the #ProCalcitonin and #WBC go up in the setting of worsening oxygenation, think superimposed bacterial pneumonia
Read 6 tweets
Starting a series on clinical Pearls I am gathering in #COVID19 patients based on experiences of many experts

Will add as we go along

Feel free to add your own observations/experiences

#covidclinicalpearls /1
Anosmia is likely the most specific #COVID19 related symptom
30% of patients have anosmia as their 1st symptom
#covidclinicalpearls /2
Around 90% of patients have fever.
50% maybe afebrile at the time of presentation
Fever tends to be very resistant to routine measures in hospitalized patients
There is no consensus that NSAIDs are to be avoided in #COVID2019 patients

#covidclinicalpearls /3
Read 66 tweets
Lessons from past #coronavirus & #influenza #epidemics suggest that #viral #infections can trigger acute coronary syndromes, arrhythmias, exacerbation of heart failure owing to a combination of a significant systemic inflammatory response plus localized vascular inflammation.
#COVID19 may either induce new cardiac pathologies &/or exacerbate underlying cardiovascular diseases. A large proportion of patients have underlying cardiovascular disease &/or cardiac risk factors. Factors associated with mortality include male sex, advanced age, comorbidities.
Acute cardiac injury determined by elevated high-sensitivity #troponin levels is commonly observed in severe #COVID19 cases & strongly associated with mortality. Acute respiratory distress syndrome is also strongly associated with mortality in patients with #SARSCoV2 infection
Read 6 tweets
After a lot of work, so proud to finally share this work on #troponin, LV function (#echofirst) and inc HF in the general pop (#ARIC)

1. ⬆️trop is assoc with LV hypertrophy and diastolic (but not systolic!) dysfx

@JAMA_current @JAMACardio @scottdsolomon
👉🏻Subjects with ⬆️trop AND diast dysfx are at particularly high risk of HF
👉🏻 LV diastolic dysfunction accounts most of the association between troponin and #HFpEF
👉🏻LV Mass accounts for most of the association between troponin and #HFrEF
Read 5 tweets
(1/10) #JACC #Tweetorial: T2MI is #cvMI due to alterations in either myocardial oxygen supply and/or demand in the absence of acute atherothrombosis. It can occur in pts w/ normal coronaries and in obstructive/non-obstructive stable #cvCAD.
(2/10) #JACC #Tweetorial: Frequency of T2MI varies widely due to differences in populations, comorbidities, adjudication processes, & cTN assays, w/ a major challenge being the absence of uniform definitions that can be useful w/ high reproducibility.
(3/10) #JACC #Tweetorial: How T2MI manifests depends on the pathobiology & clinical context, w/ T2MIs less likely to have chest pain, imaging/#ECG abnormalities & ⬇ cardiac troponin concentrations compared to T1MI. Many T2MIs are driven by other illness.
Read 10 tweets

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