Myocardial Injury after Noncardiac Surgery: A Case Report of Acute Onset Chest Pain and Elevated Troponin Levels, Challenges and Management Strategies

Abstract

Myocardial Injury after Noncardiac Surgery (MINS) is increasingly acknowledged as a significant complication that can lead to severe adverse outcomes in surgical patients. This report details the case of a 42-year-old woman who underwent craniotomy for tumor removal in the cerebellar region. On the third postoperative day, she developed acute onset chest pain. Diagnostic evaluation revealed markedly elevated cardiac troponin levels, leading to further investigation for myocardial injury.

Although the patient had no prior history of cardiovascular disease, the diagnostic workup confirmed myocardial injury consistent with MINS. This case highlights the complexity of diagnosing myocardial injury in patients who have undergone noncardiac surgical procedures. The management approach for this patient involved the prompt initiation of Aspirin, heparin, and statin therapy. Additionally, careful coagulation monitoring was performed to evaluate bleeding risk, considering the recent craniotomy.

The patient’s condition improved with the prescribed treatment regimen, demonstrating symptom relief and a significant reduction in troponin levels. This case underscores the clinical challenges associated with diagnosing and managing MINS in the context of noncardiac surgeries. It emphasizes the critical importance of early detection and the implementation of appropriate management strategies to optimize patient outcomes.

The experience from this case highlights the need for increased awareness and vigilance in the postoperative care of patients undergoing noncardiac surgeries. By addressing these challenges and refining management approaches, healthcare providers can improve patient outcomes and enhance the overall quality of care for those at risk of myocardial injury following noncardiac procedures.