Troponin is a marker of myocardial injury, not of myocardial infarction. Before labelling a patient, ask what the clinical picture says: ischaemic symptoms, ECG change and a rise or fall on serial measurements point to infarction, while a stable mildly raised value points elsewhere, such as chronic kidney disease, heart failure, myocarditis, sepsis or pulmonary embolism.
When a result does not fit the patient, repeat it and, if available, check it on a different assay platform or ask the laboratory about interference before starting a cardiac work-up.
- Interpret troponin with symptoms, ECG and a rise or fall on serial samples.
- Think of non-coronary causes: kidney disease, heart failure, sepsis, pulmonary embolism, myocarditis.
- If the result does not fit, repeat it and ask the laboratory about assay interference.
- Do not label a stable, mildly raised value as an infarction without supporting findings.
Why it matters
It keeps a laboratory number from becoming a diagnosis on its own.
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