Emergency Cases Northwest Group

064 A Shocking Result

Situation

Electrical defibrillation shocks didn't cause troponin rise.

Background

Patient 1: cardiac arrest, 1 defibrillation shock no ROSC. Troponin was 10000, died of ACS.

Patient 2: cardiac arrest, 8 defibrillation shocks and did have ROSC. Troponin was 24.

Assessment

External electrical Defibrillation shocks in themselves don't cause a troponin rise.

Recommendation

In cardiac arrest a raised troponin can be caused by many factors, including myocardial infarction.

However defibrillation shocks appear not to be one of these factors.

If the troponin is raised don’t dismiss it as simply being caused by defibrillation. Consider another cause such as myocardial infarction.

Reference

Lobo R, Jaffe AS, Cahill C, Blake O, Abbas S, Meany TB, Hennessy T, Kiernan TJ. Significance of High-Sensitivity Troponin T After Elective External Direct Current Cardioversion for Atrial Fibrillation or Atrial Flutter. Am J Cardiol. 2018 Jan 15;121(2):18

PLEASE DO NOT INCLUDE ANY PATIENT IDENTIFIABLE DATA OR GEO-LOCATION DATA IN THE SUBMISSION OR IN ANY ATTACHED IMAGES

Emergency Cases Northwest Group