Video

Thank you Doc.

What is the reason of getting 2 pattern s,type A and B according to pathophysiology and/or coronary anatomy..?

What is that normal troponin

This is brilliant Too long ive not known what people are talking about - resolved - thanks :)

L frontalis muscles

Helpful thank you!

Very useful 🙏🙏🙏🙏Thank you very much 🌹

Great video! Thank you!

Awesome teacher, God bless you for teaching and sharing ❤❤❤❤

You are very good teacher , thank you so much

4 to 5 in a week or two... stays at 4a week or two ago, then tests at 5 with cardiac symptoms and atrial flutter on EKG. The new testing seems to be causing more confusion than not, unless it is clear from other signs and symptoms that either it's an MI or not. Ultra sensitive troponin levels in a couple of hours in an ED may not show any changes, yet there can still be major symptoms, abnormal troponin levels in blood samples, especially chronic tachycardia and/or bradycardia. It seems there is far, far too much emphasis on troponin levels and not enough time in an ED to see changes that are important. To send a patient on their way without followup is likely to result in a catostraphic event, yet reliance on troponin level changes in an ED is not advisable. Find out what is causing the problem. Having a test with so many false positives or negatives, as you said, you may as well flip a coin to guess.. 50-50% chance of an MI or not, yet the patients come in with symptoms. It may not be a cardiac problem, but you should be aware of what brought a person to the ED, and be able to make a diagnosis, and not leave a patient with very comcerning symptoms and no answers. Keep in mind that different tests have different reference ranges as well. Here, we have <4 as the standard. 5+ is outside the normal of 99% of the population tested. It would be helpful to have a video about differential diagnosis of patients with heart flutter and small elevations of troponins. The 20% change could be from 4 to 5 (0.004ng/L to 0.005ng/L) or a 25%^. Possibly a small MI, maybe a difference in the test, perhaps a laundry list of other things. Most EDs here in the states aren't going to keep a patient past 2 hours, thus not long enough to make a determination. Perhaps patient education in elementary, junior high, high school, and adult populations. I'm not sure the global medical community has any handle on these newer ultra sensitive troponin tests. It may be prudent to discharge many of these patients, yet it is necessary to discover what the problem is that brought the patient to the ED. A differential diagnosis is necessary, as discharging a patient simply because they didn’t have an MI is ignoring other, just as serious issues. Differential diagnosis is a necessity, least we aren't treating patients as people, and simply as a certain condition. Is the patient breathing OK? Just asking. I literally experienced a doctor who totally missed a patient's main concern, and discharged a patient based strictly on an unchanging troponin level, yet totally missed the patient's breathing problem. It was pretty horrific.

Awesome, thank you ❤❤

Complexity made, simple, thank you thank you and thank you ❤❤❤❤❤

4.50 result of high sensitive troponin T is normal?

Great video! btw prednisone is not a trade name for prednisolone, it is a prodrug of prednisolone.

My troponin was 14. 1 hour later is was 10. EKG normal, x ray normal. Elevated blood pressure and shortness of breath was contributed to a panic attack… sound right?

This happen to me April 2023. Male 42 years old. Fit, non smoker, no drug use, no drinking Chest pain after a 15 km run. Few days in the hospital after the false positive was found

Thank youuuu

Great video thank you 😊

What is the normal troponin T level range?

Very useful , thanks a lot

Hi Richard. Thanks for the ECG example. I was just wondering how you interpret the ECG as a Mobitz type 2. I personally would only say that it is a second degree block 2:1, as I cannot compare one PR segment to the next, as there is a drop after one complex.

You hijacked my phone

Dr. Body, thank you so much for sharing you insights on this topic! It really helps me as someone who is new to this field to appreciate the important of EM research! The examples you gave made me feel more interested into this field. However, I have a question on the saving life part: do you mean that by asking more questions and conduct more experiments with patients, there is a increased chance of discovering a better treatment and therefore saving more lives? Thank you so much for the information! 11:31

Thank y❤

Thank you

Keep up this thank you

Excellent

This is the best I'm an EM/IM physician oftenly encounter this issue. I wonder if patients with Chronic kidney disease have this cuz usually those patients have baseline elevated troponin.

Well done. Please keep more of these videos coming!

Here's a link to the paper on this, led by the fantastic Ola Hammarsten, who taught me a huge amount on this important issue: www.degruyter.com/document/doi/10.1515/cclm-2023-0028/html

👏🏻👏🏻👏🏻👏🏻👏🏻

Super!

that look of seriousness in a heart attack

Thanks for this video. It's so helpful!

Hi Richard, big fan of your content. I'm a healthy, 33 year old athlete and Soldier in Alaska. I recently went to the ER because I was feeling a little panicky with some chest discomfort. They said I had elevated troponin levels. During my visit they tested me twice and the results were the same. The levels neither decreased or increased. They checked for blood clots and that was negative. They also did an ultrasound of my heart and said there was no damage. I'm very unfamiliar with the troponin tests. I watched your video on high sensitivity troponin tests tonight and found the information very educational. I've been having some anxiety post ER visit. I'm a bit of a gym rat and don't want that lifestyle to change. I've been pushing my body very hard lately in the gym ding both high intensity cardio and weightlifting. I'm not asking for a diagnosis, but could the troponin levels just be from fatigue and pushing myself in the gym without adequate rest? Thank you! -Seth .

MAKE MOAR ECG VIDEOS !!!!!!!! these are brilliant

Thank you for this video, I’d love to know why Cardiologist say “don’t worry” when I’ve consistently had mildly raised Troponins for the past year or so - but ….ECG , Cardisc MRI , CT angiogram show heart is fine no damage?

I spend 3 weeks looking up various resources on how to search Medline and Embase but yours was the clearest I've ever come across. I feel like I've seen a light. Thanks for doing this video

Amazing

Thank you very much for this great explanation. 👍👍👍👍👍👏👏👏👏👏

Best and most straight to the point video on youtube thanks a lot

I have no access on EMBASE , ANY one can help

how to differnentiate j point elevation from stemi, one video plz

in v1, v2, first deflection is downward, so, is not that q wave?

Very nice lecture ..

Great! Thank you 😊

how do you filter for clinical trials, thanks for the video, very helpful!

thanks for the lecture...very informative and detailed. I had the test done here recently in our er and it saved my life! so I am most interested in your work and analysis...keep it up!

Excellent talk thanks so much