Is It Really A Heart Attack? NON STEMI VS NON SCHESTEMI

Today the house staff were perplexed when a female patient with a low level troponin elevation and with a terrible story for unstable angina  had a normal coronary angiogram. Why would a patient with the diagnosis of a non ST elevation MI have normal coronary arteries they asked? The answer is a troponin elevation is sensitive but not specific and does not equal MI without 12 lead ECG changes or segmental wall motion abnormalities (2D Echo). Low level troponin elevation without ECG changes is a NON SCHESTEMI. So this day forward a poor story for unstable angina without ECG changes or wall motion abnormalities and with a normal coronary angiogram is a NON SCHESTEMI (Should of CHecked the EcgSTEMI).

Milford Sound Queenstown

                The most beautiful glacial lake in the world in the Southern Alps of New Zealand