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Clinical Crossroads Update
November 2, 2011

Update: A 43-Year-Old Man With Angina, Elevated Troponin, and Lateral ST DepressionManagement of Acute Coronary Syndromes

JAMA. 2011;306(17):1911. doi:10.1001/jama.2011.1568

In a Clinical Crossroads article published in February 2010,1 Duane Pinto, MD, MPH, discussed the pathophysiology, management, and treatment of acute coronary syndromes/non–ST-segment elevation myocardial infarction (ACS/NSTEMI). The patient, Mr C, was a 43-year-old man admitted to the emergency department after experiencing nausea and a burning sensation in his throat while running. An electrocardiogram showed lateral ST-segment depressions and T-wave inversions. Creatine kinase measurements were normal but his troponin T was elevated at 0.39 ng/mL. Coronary angiography showed diffuse 3-vessel disease and he was admitted for coronary artery bypass graft (CABG) surgery.

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