NEW YORK, NY – Have you ever groaned because someone checked a troponin on a patient without chest pain or shortness of breath and, of course, it was elevated? A new study in the New England Journal of Troponins (NEJT) revealed that 99% of health care practitioners are walking around with some kind of troponin leak, further supporting that pretty much anything can cause it.
“Our healthcare practitioners have some pretty wonky troponins from work alone,” said lead researcher and cardiologist Catherine Hart. “I’m pretty sure I have a mild troponin leak when I get a consulted about a mild troponin leak.” She did; it was 0.11.
In the NEJT study, researchers checked troponins on health care practitioners at multiple points during their work day. Dehydration, forgetting to eat or pee, drinking coffee, having a bowel movement, hearing a request for Dilaudid, and hearing a pain score greater than 10 were common reasons for a health care practitioner to develop a leak.
“In fact, we found that a patient’s pain score divided by 100 equals their health care practitioner’s troponin level,” commented Hart, whose troponin was now 0.08.
The pager was the number one cause of troponin leaks, as well as seizures, migraines, and post-traumatic stress disorder (PTSD), in health care practitioners who carried them. Medical students saw high troponins due to pimping. Radiologists, microbiologists, and nocturnists developed troponin elevations in response to sunlight.
Endless documentation is another common cause of leaks.
“For those with electronic health records, staring at a computer bumps your troponin, typing bumps your troponin, and double-clicking bumps your troponin,” added Hart, whose troponin is now 0.07. “For those with paper charts, handwriting causes troponin leaks, paper cuts cause troponin leaks, and putting the chart back in the cubby causes a troponin leak.”
Despite these study findings, Hart still cautions that there is always a time and a place when it is appropriate to check troponins.
“Of course, a classic chest pain story is one scenario,” explained Hart, who is now NPO for a stress test in the morning. “The other scenario relates to our hardworking health care personnel in the trenches. If that book of delivery menus goes missing, check an ECG and check a troponin right away! TIME IS OF THE ESSENCE!”
