Podcast #224: Troponin

Author: Sam Killian, M.D.

Educational Pearls

• Not every troponin elevation is an MI.
• Trop elevates in about an hour in ACS and stays elevated for days.
• Non-MI conditions that cause elevated troponin: Critical illness (sepsis), increased cardiac demand, right heart strain, LV dysfunction, hypotension, pressor use, acute PE, SAH, chronic renal failure, CHF, aortic dissection, and peri/myocarditis.
• Elevated troponin in settings other than MI is correlated with increased mortality.

References: Korff S, Katus HA, Giannitsis E. Differential diagnosis of elevated troponins. Heart. 2006;92(7):987-993. doi:10.1136/hrt.2005.071282.