| [ Summary ] |
According to the guidelines, acute myocardial infarction is diagnosed based on typical chest pain, electro-cardiogram (ECG) abnormality, and troponin level. ECG and troponin tests have high sensitivity and specificity. However, in dialysis patients, it is difficult to apply these diagnostic steps. Many dialysis patients are asymptomatic due to diabetes. ECG abnormality is frequently observed at baseline in these patients because of hypertensive heart disease or abnormal potassium level. Dialysis patients also have a high troponin level at baseline. It is always pseudo-positive. Thus, it is difficult to use these guidelines in dialysis patients. |