NASHVILLE, TN – After seeing her patient with chest pain develop a mild troponin bump up to 0.25 on this morning’s set of labs, new Vanderbilt University internal medicine intern Melanie Izard has herself experienced a mild troponin bump up to 0.22.
“When [my patient’s] troponin came back elevated, I could feel myself develop some substernal chest pain, 6 out of 10, associated with mild shortness of breath and palpitations,” explained Izard, who ordered a set of stat cardiac enzymes on herself when this happened. This is Izard’s first patient with chest pain since becoming an intern. “I was hoping for a straight forward chest pain rule-out.”
According to Izard’s senior resident Matt Bayless, the intern’s patient has no ST-T changes on electrocardiogram. In fact, the same holds true for Izard’s ECG: no ST-T changes as well. Both the intern and her patient have had no significant events on telemetry outside of occasional PVCs (premature ventricular complexes). Currently, Izard and her patient are chest pain free, and Izard plans to continue trending troponins on both the patient and herself.
“I hope my patient’s cardiac enzymes start trending down because that’s my best hope for having my own troponins improve,” Izard confessed to Gomerblog, who just took an aspirin and is having a lipid profile checked. “Otherwise, I’m going to have two new consults for cardiology. Is it normal to make both my patient and I NPO after midnight?”
