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Now you have ECG and troponin evidence of ischemia, AND ventricular dysrhythmia, which means this is NOT a stable ACS. Troponins may be negative with very rapid reperfusion, or measured too late, or chronically elevated due to cardiomyopathy or renal failure. Again, cath lab was not activated. What does this troponin level mean?
If our valves are leaky then again, a smaller volume of blood is effectively ejected because some leaks back Cardiomyopathies – if the heart muscle itself is defective in some way then that makes it weaker. This includes conditions like familial hypertrophic cardiomyopathy, familial dilated cardiomyopathy etc.
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