EMERGENCY CASEBOOK
Acute rheumatic fever mimicking an acute coronary syndrome
1 Department of Cardiology, The James Cook University Hospital, Middlesbrough, UK
2 Department of Infectious Disease, The James Cook University Hospital, Middlesbrough, UK
Correspondence to:
Correspondence to:
Dr A J Turley
Cardiothoracic Division, The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW, UK; a.turley{at}btopenworld.com
An elevated troponin measurement does not always reflect myocardial ischaemia secondary to obstructive coronary artery disease. Troponin levels can also be elevated in other disease states including pulmonary emboli, myo-pericarditis, acute rheumatic fever, and in the critically ill. Thus, patients presenting with chest pain and electrocardiological and biochemical evidence of myocardial necrosis are not always suffering from an acute coronary syndrome.
Keywords: acute rheumatic fever; carditis; Duckett Jones criteria; ST elevation; troponin
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