[A high troponin value: about a favourable evolution case]

Cardiac troponin I (TnIC) is a sensitive and specific marker for myocardial injuries. A part from its diagnosis character, troponin is a major element for mid term prognosis with regard to occurred cardiovascular events. We are reporting the case of a 56-year-old man admitted to hospital for an inaugural myocardial infarction with positive evolution despite a very high level of troponin (1200 ng/ml) in post re-vascularisation. The context of moderate risk factors and the early re-vascularisation probably contributed to a favourable evolution of the patient. A very high troponin value seems to be more in favour of an effective re-perfusion rather than a mid term prognosis factor in this case.

[Hemodynamic instability and long-term lithium therapy]

Lithium is known to be responsible for many adverse events on the cardiovascular system. Among these events, it was experimentally noted that lithium could block the action of catecholamines on myocardium. The authors report the case of a patient under lithium therapy developing a myocardial infarction secondarily complicated of a severe cardiac failure. The inotropic support essential to balance hemodynamic could be raised only after lithium's stop. This example could be a clinical translation of the experimental effect previously observed.