what had happened ?
In the morning Hubby went to a cardiologist to take a stress ECG which was cancelled due to his physical condition. He needs to have a stress ECG to get his stomach surgery to fix internal bleeding, and he needs to be off blood thinners to go ahead with the surgery ... It's only been a year since his 3rd heart attack, so he is still on blood thinners, and surgery is a problem. As is covid vaccination btw ...
Anyway, the stress ECG was cancelled, a blood sample was drawn and forwarded to the lab. He did a normal ECG and was sent home.
at about 3:45 pm the cardiologist called to tell him that they found troponin in the blood sample which is an indicator of heart muscle tissue death, which in turn is an indicator of an ongoing heart attack and that he called the rescue services, Hubby should grab his stuff as the Chest Pain Unit in the next larger hospital was already informed.
Which he did. I informed by boss about a family emergency and told him that I was off for the rest of the day, the ambulance came by, as did the emergency physician and they lugged him into the Mayence university hospital CPU. (which does not allow relatives due to Covid ...)
There they continuously monitored Troponin levels plus the other markers and did their ECG. Fortunately they could not confirm the initial diagnosis, found problems with his potassium levels (which would explain his blood pressure problems) and told him that he really needed to get his stomach and esophagus fixed.
He is back home, and it seems that the decision to move to a place about 10 km away from the next large hospital complex was foresighted and prudent ...
It is not a good sign if you have to choose the place you want to live at with vicinity to emergency services as the main criteria ...
That's interesting. So Hubby was off for a stress ECG? Has he been exercising in anticipation of this? The reason I ask is that Troponin is a cardiac specific marker for cardiac muscle
damage, not necessarily cardiac muscle cell
death and you can find raised levels in people who've been getting cardiovascular exercise that is vigorous enough to promote cardiac muscle remodelling*. So its possible to get a false positive suggesting heart damage when in fact it's in the process of getting stronger.
I'm not suggesting that this
is what has happened here but it's worth being aware of and drawing the medic's attention to the possibility if Hubby has a "type A" personality and has been doing the physical equivalent of swotting up before an exam.
They used to use a less specific test for Creatine Phosphokinase for the same purpose and you can find elevated CPK levels from skeletal muscle as well as from cardiac muscle. That's lead to some panics where athletes have been having routine tests and someone just saw the test numbers and didn't take all the circumstances into account. It happened to me in my fifties when I'd been hospitalised because of an asthma attack. They'd run a large panel of blood tests, more than were necessary because of why I was there (I suspect they do that in patients "of a certain age" in case they can catch something before it becomes a problem while they've got ahold of you), and found raised CPK levels. Lucky I was clued up enough to divert them from unnecessarily referring me to cardiology on top of having thoracic consultants buzz around me. They tend just to see the patient in front of them who is currently as weak as a kitten and forget that the same patient the day before may have been perfectly capable of indulging in exercise tough enough to floor a thirty year old (in my case some heavyweight interval training on the bike) before an
allergic response dumped them in a hospital bed.
*
Rifai N, Douglas PS, O'Toole M, Rimm E, Ginsburg GS (April 1999). "Cardiac troponin T and I, echocardiographic [correction of electrocardiographic] wall motion analyses, and ejection fractions in athletes participating in the Hawaii Ironman Triathlon". Am. J. Cardiol. 83 (7): 1085–9. doi:10.1016/S0002-9149(99)00020-X. PMID 10190525.
Neumayr G, Gaenzer H, Pfister R, et al. (February 2001). "Plasma levels of cardiac troponin I after prolonged strenuous endurance exercise". Am. J. Cardiol. 87 (3): 369–71, A10. doi:10.1016/S0002-9149(00)01382-5. PMID 11165984.
Urhausen A, Scharhag J, Herrmann M, Kindermann W (September 2004). "Clinical significance of increased cardiac troponins T and I in participants of ultra-endurance events". Am. J. Cardiol. 94 (5): 696–8. doi:10.1016/j.amjcard.2004.05.050. PMID 15342317.