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The rise and fall of troponin in a patient with polymyositis
  1. Faiza Javed and
  2. Stephanie Leung
  1. University of Kentucky, Lexington, Kentucky, USA
  1. Correspondence to Dr Faiza Javed; fja228{at}


Troponins are an excellent sensitive marker for myocardial ischaemic damage. However, there are several non-ischaemic cardiac and non-cardiac reasons for troponin elevation. Many cases of troponin T elevation and some troponin I cases have been reported in the literature due to inflammatory muscle disease. Here, we report a woman in her 50s who initially presents with fatigue and weakness, and is found to have elevated troponin T. The patient was appropriately worked up for cardiac causes with ECG and echocardiogram. She had positive antinuclear antibodies, antineutrophil cytoplasmic antibody and myositis panel. The elevation of troponins was attributed to polymyositis and treated with methotrexate and prednisone with recovery of patient’s symptoms. This article emphasises the struggle of diagnosis in a patient with no reported medical history, having low to moderate risk of silent myocardial infarction.

  • Cardiovascular system
  • Drug interactions
  • Orthopaedics

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  • Contributors FJ and SL were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content. FJ reviewed the data and wrote the case reports including summary, presentation, discussion, conclusion and created the figure. SL took care of the patient during inpatient admission. She also reviewed and edited the final draft. Both the authors are guarantors of the report. FJ and SL gave final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.