“A Study to Assess the Relationship between Chest Pain and Elevated Troponin Levels in the Presence and Absence of Myocardial Infarction, Among Patients Admitted to Critical Care Units at Selected Hospitals.” “Chest Pain & Troponin Levels Related to Myocardial Infarction”


Authors : Shabiya; Dr. M Bharati

Volume/Issue : Volume 5 - 2020, Issue 8 - August

Google Scholar : http://bitly.ws/9nMw

Scribd : https://bit.ly/3iu7zfA

Troponin refers to three different proteins. Troponin C binds calcium and transports troponin I so that muscles can contract. Troponin T binds troponin proteins to muscle fibers. The heart is essentially a muscle, and damage to the heart causes it to release troponin into the bloodstream. Troponin levels in the blood are normally very low, but injuries to the heart can cause the levels to increase significantly.1 Cardiac troponin T (cTnT) and troponin I (cTnI) are the most specific and sensitive laboratory markers of myocardial cell injury and therefore have replaced creatine kinase MB (CK-MB) as the gold standard. A rise of troponins reflects irreversible myocardial cell necrosis. Lower but elevated troponin levels may point to another diagnosis. Accordingly, abnormal values have been described in various conditions not related to acute coronary disease, such as myocarditis, pulmonary embolism, acute heart failure, septic shock, kidney failure, heart failure, or a traumatic injury to the heart. Heart damage from using recreational drugs, such as cocaine, chemotherapy-related damage to the heart and as a result of cardio-toxic drugs as well as after electrical cardio-versions. 2  Aims: The aims of this study are as follows:  To asses troponin levels among patients with chest pain  To find the relationship between chest pain and elevation in troponin levels  To find the relationship between chest pain and troponin levels in patients with myocardial infarction  To find an association between chest pain and elevated troponin levels in patients with absence of myocardial infarction  To find an association between elevated troponin levels with selected demographic variables.  Materials and Methods: Study approach- Descriptive observational research approach. The study includes determining the association between independent variable in terms of chest pain and its association with troponin levels among patients with Myocardial infarction and without myocardial infarction with cross sectional study design was used. The population involved in this study was patients having chest pain on admission to the hospital in Bangalore. By non-probability convenient sampling a total of 150 patients were included from critical care units of selected hospitals of Bangalore. A Structured questionnaire and check list on socio-demographic factors, co morbidity, presenting symptoms, ECG Variations, and troponin levels. Data was collected by patients admitted in selected hospitals of Bangalore through self report method.  Results: Mean troponin level 0-6 Hrs after chest pain was 30.55 with minimum troponin level 16.5, maximum troponin level 32.1and with the standard deviation of 24.27. Mean troponin level 6-12 Hrs after chest pain was 29.07 with minimum troponin level 14.8, maximum troponin level 42.3 and with the standard deviation of 7.65. Mean troponin level 12 Hrs after chest pain was 29.28 with minimum troponin level 17.7, maximum troponin level 50.7 and with the standard deviation of 7.67. There is no significant association between sociodemographic variables of patients like age, gender, smoking, hypertension, hypercholestromia, liver disease, chronic kidney disease, bypass surgery and angioplasty with troponin levels 6 Hrs after admission. But there is a significant association between variables like myocardial infarction with troponin levels 6 Hrs after admission.  Conclusion: After thorough analysis of the data, researcher concluded that there is no significant association between socio-demographic variables of patients like age, gender, smoking, hypertension, hypercholestromia, liver disease, chronic kidney disease, myocardial infarction, bypass surgery and angioplasty with troponin levels 3 Hrs after admission. But there is a significant association between variables like diabetes mellitus with troponin levels 3 Hrs after admission. And no chest pain is found among the patients without MI. out of 150 patients only 4 patients are there with chest pain without MI. hence the association could not be found.

Keywords : Troponin levels, chest pain, hypercholestromia, myocardial infarction

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