Serial determination of troponin concentrations in the diagnosis of acute myocardial infarction

Contemporary guidelines for the definition of acute myocardial infarction recommend the presence of an increase or decrease in troponin concentration in patients presenting to the hospital with chest pain and electrocardiogram changes. Here we report the case of a 49-year-old woman with recurring chest pain, nausea, and diaphoresis with initially undetectable troponin concentrations that subsequently increased. This case demonstrates the importance of serial determination of troponin concentrations and changing biomarker patterns in the management of patients presenting with possible cardiac ischemic injury.