Is a Cath Really Necessary?

Abstract

Samantha Gelman, Andrew Benin, Javad Savoj, Rajesh Gulati and Kaustubh Patankar

Pulmonary embolism is associated with elevated troponin levels. Many conditions are known to cause this and are thus regarded to as an NSTEMI in the setting of demand ischemia. We present a 78-year-old male with multiple comorbidities who is found to have an NSTEMI in the setting of a pulmonary embolism. The patient subsequently undergoes catheterization and is found to have mild coronary artery disease. Catheterizations are procedures that come with their own set of risks and may not necessarily need to be performed if troponinemia is deemed to be from demand ischemia. Currently, there is no cut off point for which patients who present with an NSTEMI secondary to these other underlying conditions should undergo catheterization. Further research should be done to determine troponin cut offs in pulmonary embolism and the need for additional evaluation via catheterization.

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