Review article: Elevated troponin: Diagnostic gold or fool's gold?

Troponin is a highly sensitive biomarker of myocardial injury and has been used extensively in everyday clinical practice in the community as well as in hospitals for the diagnosis of acute myocardial infarction (AMI) and for risk stratification of patients with acute coronary symptoms. Dynamic elev...

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Bibliographic Details
Published in:Emergency medicine Australasia 2014-04, Vol.26 (2), p.125-130
Main Authors: Rahman, Atifur, Broadley, Simon A
Format: Article
Language:English
Subjects:
Biomarkers - blood
Coronary Disease - diagnosis
diagnosis
Emergency Service, Hospital
Humans
Myocardial Infarction - diagnosis
myocardial injury
non-cardiac
review
troponin
Troponin - blood
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Summary:Troponin is a highly sensitive biomarker of myocardial injury and has been used extensively in everyday clinical practice in the community as well as in hospitals for the diagnosis of acute myocardial infarction (AMI) and for risk stratification of patients with acute coronary symptoms. Dynamic elevations in biomarkers (troponin) are considered fundamental to the diagnosis of AMI. Unfortunately, many clinical conditions can cause troponin elevation in the absence of myocardial ischaemia, and elevated levels sometimes pose a diagnostic dilemma. In some cases, inappropriate diagnosis of ‘AMI’ based primarily on a raised troponin can have a deleterious impact on an individual, including on driving, insurance and other medicolegal matters. An incorrect diagnosis of myocardial infarction can also lead to the oversight of serious life‐threatening alternative causes of troponin elevation (e.g. pulmonary embolism). This article discusses the role of troponin in our everyday clinical practice in the ED.
ISSN:1742-6731
1742-6723
DOI:10.1111/1742-6723.12203