Lab Studies:
White blood cell count was 5.26, hemoglobin was 7.1, platelets was 383, MCV was 67, and RDW was 18. Her iron level was 18, TIBC was greater than 518, transferrin saturation was less than 3, and ferritin was 12. She had elevated high sensitivity troponin which peaked at 29. But, she had a normal comprehensive panel, hemoglobin A1c, thyroid stimulating hormone, haptoglobin, and lactate dehydrogenase. Her urine toxicology screen was negative.
Other Studies:
ECG showed ST elevations in V2, V3, V4 with reciprocal ST depression with T-wave inversions in leads II, III, and aVF which prompted an immediate transfer to the emergency room for concern of acute coronary syndrome Case Photo #1
Cardiac MRI and CT chest were normal.
Echo showed normal size ventricles with EF of 66%, no signs of valvular or wall motion abnormalities, LV wall thickness was 1.1 cm and 1.3 cm in the septum and posterior wall respectively.
Consultations:
Cardiology was consulted after ECG showed ST elevation in the setting of elevated high sensitivity troponin.
A cardiac catheterization was considered but deferred as the high sensitivity troponin downtrended.
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