A troponin in serum of more than one Million in vivo is rare insult. We report a case of 85-year-old woman who was transferred to our institution because of acute ST elevated myocardial infarction and the troponin level reached a peak of 1,032,904.2 pg/ml. She was discharged with highly reduced left ventricular function, however in the three months follow up after a coronary bypass operation she completely was free from heart failure symptoms and echocardiography showed a totally normal function of both ventricles. This case study highlights that the initial serum troponin in acute settings can mislead the long-term prognosis and gives prominence to the expeditious myocardial revascularization.
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