Elevated troponin in a patient with pneumomediastinum and pneumothorax: a diagnostic challenge
Year: 2025
Type: article
Study design: Case Report
Abstract: We present the case of a middle-aged man who was admitted with acute chest pain and markedly elevated troponin levels, initially raising concerns for acute coronary syndrome. Diagnostic evaluations revealed an apical pneumothorax, and pneumomediastinum, without evidence of dynamic ischaemic ECG changes. Despite the concerning elevation in troponin levels, minimal variation in serial measurements (<10%) indicated a non-ischaemic aetiology. The troponin elevation was attributed to stress from pneumomediastinum, localised inflammation and myocardial strain. This case highlights the importance of differentiating ischaemic and non-ischaemic causes of troponin elevation to avoid unnecessary interventions. Conservative management focused on diagnostic stewardship resulted in a favourable outcome. Given the rarity of such presentations, we aim to publish this case to enhance understanding and emphasise the importance of considering pneumomediastinum in patients presenting with chest pain and elevated cardiac biomarkers. .
Source: BMJ Case Reports
Authors: Dissanayake Mudiyanselage Chanaka Jayawardena, Rohan Suthar, Benjamin Sutton, Joseph De Bono
Institution: University Hospitals Birmingham NHS Foundation Trust
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4416959826