ECHO
Marathons confuse diagnosis of MI
| The first 150 words of the full text of this article appear below. |
A small study of non-elite marathon runners has cast new light on cardiac troponins, with implications for diagnosing non-ST elevation myocardial infarction (MI).
International recommendations of raised troponin T value as an indicator of acute MI are not definitive, it seems, if the subject has engaged in prolonged exercise.
Cardiac troponin T (cTnT) values in blood rose to >0.01 µg/l from below 0.01 µg/l—the detection limit of the assay—among more than three quarters of 72 non-elite runners in the London marathon. In almost 60% of them values were >0.03 µg/l; in 36% >0.05 µg/l—the current recommended cut off for acute MI—and in 11% >0.1 µg/ml. Ischaemia was not evident on electrocardiography (ECG), but after the race the ratio of early to late left ventricular filling (E:A) dropped significantly. Raised cTnT was unaffected by age, race time, or changes in ventricular filling. Such results, when combined with dyspnoea, chest tightness, and
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