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Wednesday, February 3, 2016

Elevated Troponin

emDocs - February 2, 2016 - Author: Smith C - Edited by: Koyfman A and Long B
Conclusion
A troponin elevation does not mean it’s ACS. At the end of the day, troponin is a tool and nothing more. Physicians must take into account the entire clinical picture: history, exam, ECG, baseline labs, response to treatment, clinical gestalt, etc. Several studies have suggested that in ACS, the initial troponin I on average is higher than elevations in non-ACS cases, with a median troponin of 0.14 ng/mL. This can be just another tool to decipher the diagnosis causing an elevated troponin in our patients.
However, the critical step is to realize that not every elevated troponin is cardiac in nature. We must be wary of tunnel vision and broaden our differential because if we don’t, we risk missing high morbidity/mortality entities.