Examples of reported elevations of cardiac troponin
| AMI, acute myocardial infarction; CABG, coronary artery bypass graft; CAD, coronary artery disease; IHD, ischaemic heart disease; MI, myocardial infarction; PTCA, percutaneous transluminal coronary angioplasty; RTA, road traffic accident; SLE, systemic lupus erythematosus. | ||
| Primary ischaemic cardiac injury | ||
| Thrombotic coronary artery occlusion caused by platelets/fibrin | ST elevation MI | |
| Non-ST elevation MI (previously non-Q wave AMI plus troponin positive unstable angina) | ||
| Secondary ischaemic cardiac injury | ||
| Coronary intervention | Primary PTCA | Distal embolisation from clot or atheroma; side branch occlusion |
| Elective PTCA | Distal embolisation from atheroma or debris; side branch occlusion | |
| CABG | Global ischaemia from inadequate perfusion, myocardial cell protection or anoxia | |
| Sympathomimetics | Cocaine | |
| Catecholamine storm | Head injury, stroke, intracerebral bleed | |
| Pulmonary embolus | Presumed right heart strain or hypoxia | |
| Coronary artery spasm | Small percentage of patients only | |
| Coronary artery embolisation | Clot | |
| Air | ||
| CABG | ||
| Coronary artery inflammation with microvascular occlusion | Vasculitides | |
| Connective tissue disease | ||
| SLE | ||
| End stage renal failure | More severe CAD but 50% have normal coronaries | |
| Rhythm disturbances | Prolonged tachyarrhythmia or bradyarrhythmia with IHD | |
| Acute heart failure | Only if caused by IHD | |
| Direct coronary artery trauma | ||
| Extreme endurance exercise | Extreme marathons | Wall motion abnormalities |
| Extreme training | cTn +ve deaths presumed caused by extreme oxygen debt producing ischaemia | |
| Non-ischaemic cardiac injury | ||
| Known causes of myocarditis | Infection | Bacterial |
| Viral | ||
| Inflammation | ||
| Auto-immune | Polymyositis | |
| Scleroderma | ||
| Sarcoid | ||
| Drugs | Alcohol | |
| Chemotherapy | ||
| Inflammation | ||
| Cardiac trauma | Direct | RTA |
| Stabbing | ||
| Cardiac surgery | ||
| Metabolic/toxic | Renal failure | |
| Multiple organ failure | ||