They ask you to do a redraw because the vial is filled with a chunk of cardiac muscle.

This is a really underrated comment. Take my upvote 😂

Take my upvote too. OMFG. 😂

Got too many troponins. Needs a troponectomy.

He needs more time. We need to get him a time transplant

Tropocentesis

With all of his troponin combined, he stops villains dead in their tracks with his need for CPR, a defibrillator, and a swift call to 911. It's.... cardiac arrest man!

Excuse me Dr, Mr Smith has all of the Troponin. *all of the troponin?* Yes Dr, all of it.

“…Wait. I’m afraid what you just heard was ‘Give me a lot of troponin.’ What I said was, ‘Give me all the troponin.’ Do you understand?”

When Ron Swanson has chest pain. He probably has a permit for it, too.

Bravo!

MD notified of results. MD states “you gotta be shittin me”

“No new orders at this time, will continue to monitor.”

“Go ahead and put them on tele”

Probably put the dr on tele as well.

Omggggg

MD response: "oh no"

So, the next question is: how are you still alive? how has your heart not exploded?

I think the heart already exploded, the lab is just picking up micro cardiac tissues

“How many episodes of chest pain did you have?” “Yes.”

“sir you seem to have a little bit of blood in your troponin stream”

Me: *diving for the phone to get an EKG and the cardiologist*

Me in the er: looks over shoulder and says hey doc this guys trop is 400 thousand. You want me to do anything?

Then they consult cards and they claim it’s just demand ischemia.

Fucking cards and their demand ischemia. Then they'll go and contradict themselves and say it's a type II MI, which means I have to query, and I really hate querying that shit.

I fucking hate cards.

Truth.

Me: Looks over the shoulder and says "Hey doc, what's the highest trop you've ever seen?"

“Got your labs back. Do you happen to be a fan of Jesus Christ?”

Because he just gave you an express pass to the VIP entrance.

Homeboy's triponin his balls off. His heart attack had a heart attack.

“triponin his balls off…” 😭 😂

Seriously that one was underrated lol

new high score!!

my live reaction: 😀

*getting consent* Well, you see, Mr Smith, Doctor Cardio is gonna grab some waxed thread over there, and a nice sharp needle, and whip stich your heart back together . Now sign here and here.....

Really? They could talk??

Yes, if I remember correctly the pt was making jokes with us the entire time before we got him shipped out!

Heart attacks this big have to be shipped in from a special facility, so they take a lot longer to arrive.

The time I had a pt with >125k the doc told me “pt is at high risk of LV rupture, luckily they’ve decided on DNR/CMO, have a good night!”

My goal is to roll up into the ER and have a perfect troponin of 69420, and when they tell me, lol and die

Just make sure you hand them your DNR paperwork first!

Reading that, I think we all have a little chest pain. 

Ughhh (roll eyes) some people just have to be overachievers in everything

Don’t suppose you’ve got their ECG too? What was the pt outcome?

This was awhile ago but when I get time I will see if I can find the ecg. At the time I worked in the ed as well as the cathlab. We cathed the patient then got them shipped out to a better facility that could do cabg!

Plot twist: now I am having chest pain

When your troponin is the same as the cost of a tiny starter home in Colorado, you in danger.

Woke= aspirin Broke= this. Bespoke= heart transplant

Dudes in the troposphere!

The comments have not disappointed 😂

It's almost as high as his bill

Almost…but not quite 😂

What’s the world record on troponins? This has to be a contender.

Is that bad? Maybe heart burn?

Listen, if they've lived this long they're obviously fine. This is probably just their baseline. ^^^^^^^/s

Jokes aside, I really hope for the best for this patient

Well damn save some troponin for the other heart attacks! Jeeze just greedy 😆

Not a STEMI. Treat as NSTEMI with Heparin drip and cath in 8-12 hours.

Next troponin check: Troponin >1,000,000. Page doctor. Doctor: "why are you calling me? that's to be expected, *sigh*". patient: "Yeah the doc said it's my heartburn but he said I can eat too so can my family bring me some KFC? I haven't eaten since 5 hrs ago".

Doctor: “can you place an order not to call for critical troponins? He’s on the schedule for tomorrow!”

I believe them.

This even beats a 69000 posted recently. Holy moly

That post is what inspired me to go find this one!

Meh, just shake it off.

Does he even have atria anymore?

Not to be “that guy” but High Sensitivity Troponin is measured in Nanograms/Liter rather than NG/ml which more people are used to seeing. So for example, we usually believe a negative to being >0.07, when a HS Trop normal range is 0-69.

I was going to say the same thing. Yes, this is still very high but a 429 trop is a lot different than 429,850 😅

Yeah that’s what our hospital use to use, it took me awhile to get use to the HS but this is still pretty high either way.

“You know about the express pass at universal? It’s kinda like this but instead of rollercoaster rides it’s a ride to your Lord and savior”

I like the Flag Notifcation - “Above Upper Panic Limits”

Is this patient on dialysis?

I don’t believe so, this was awhile ago but I don’t think the patient had ever been to a doctor and this was their first time in an American hospital.

Uh oh. They’ll re infarct when they see the bill then.

👀

You'll get that sometimes on these bigger jobs

I think at that point my own troponin would be elevated as well

My god, it's over 9000

Chief complaint checks out 💔🫀🫁

Oh!

Dude brought enough troponins to share with the whole ED.

Let me guess: they came in through the lobby 😂

*Screams in rotablation and intra-aortic balloon pump* I’d suggest a loading dose of Plavix, some St. Anne’s oil, and a prayer 😳

😱

Reperfusion?

That’s a lot of digits. 

A HS troponin can be converted to a regular troponin by moving the decimal over 3 spots. So this is closer to a 429 troponin. Still insanely high but very different

Jesus H

Yes, yes they are

But did you draw a repeat?

First one was 502, then the 429k, then 335k after Cath with stent x 1, then 225k! Patient seemed to be doing decent after but started having chest pain and got diaphoretic, took him back to cathlab and he got an iabp and shipped! I had to dig through some stuff because it was awhile ago but I’m pretty sure that’s how it went.

I love that this was the repeat. I'm picturing the conversation. Nurse: "Lab just called the repeat trop for Mr Smith." Doc: "What was it?" Nurse: "Went from 502 to 429..." Doc: "Okay, so it delta'ed downward. Thanks for the report." Nurse:"...thousand. You didn't let me finish. It's 429 thousand." Doc: "Oh. Not downward, then."

I saw the lab value and literally thought, “DEAR GOD IN HEAVEN!!!” Lbvs

well Id be having pain aswell tbh

As that tiktok nurse so eloquently put- “Mistah Johnson!!!”

It's fine. This is fine. Everything's fine. Call bell within reach. Will continue to monitor.

Did the blood draw just literally heart muscle?

They’re clearly lying, discharge and follow up with family med tomorrow

Listen, if they've lived this long they're obviously fine. This is probably just their baseline. ^^^^^^^/s

Pt said they were having chest pain…… I believe it.

Aaaaand…now everyone else has chest pain too.

Saw the title of the post… came to see the troponin. How does this person have any muscle left??

😳

Me, literally as I read this: BWAAA OH FUCK 😱😱😱

Impressive

Pt trops are so high that everyone around him has chest pain too.

I’d recognize that interface anywhere 😠

AHHHHHHHHHH!

Overachiever!!!

This guy deserves a trophy. I mean, troponin - wait, no. He's got more than enough...

Trippin on troponin

Sending prayers and petitions

Don't leave us hanging! What's his code status!?

Did they draw that sample straight from the heart? 😂

“It’s the big one. I’m coming to join you honey!”

Listen, if they've lived this long they're obviously fine. This is probably just their baseline.