Letters

Raised cardiac troponins: Troponin is raised in pre-eclampsia

BMJ 2004; 329 doi: http://dx.doi.org/10.1136/bmj.329.7457.111-a (Published 08 July 2004) Cite this as: BMJ 2004;329:111
  1. Adam Morton, endocrinologist and obstetric physician (amorton{at}mater.org.au)
  1. Mater Hospital, South Brisbane, QLD 4101, Australia

    EDITOR—In their editorial on raised cardiac troponins Ammann et al omit an important cause of increased troponin concentration in obstetric medicine—gestational hypertension and pre-eclampsia.1

    Fleming et al showed fivefold higher median values for cardiac troponin I in preeclamptic women than in normotensive pregnant women.2 These median values were above those which would be indicative of significant myocardial damage. Awareness of this becomes important in women with severe pre-eclampsia complicated by pulmonary oedema, the pathogenesis of which is likely to be multifactorial related to capillary leak, hypoalbuminaemia, hypertension, and global left ventricular dysfunction. It is also important as the other commonly used marker of myocardial ischaemia, the MB isoenzyme of creatine kinase, is raised in around a third of normal pregnant women on the first postpartum day after vaginal delivery.3

    Footnotes

    • Competing interests None declared.

    References

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