Elevated cardiac specific troponin concentration in the absence of myocardial infarction. Part 1

DOI: https://doi.org/10.29296/25877305-2020-03-04
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Issue: 
3
Year: 
2020

A. Chaulin(1, 2); L. Karslyan(1, 2), Candidate of Medical Sciences; A. Aleksandrov(3); Professor I. Duplyakov(1, 2), MD (1)Samara Regional Clinical Cardiology Dispensary, Samara (2)Samara State Medical University (3)OOO «INVITRO-Samara», Samara

Elevated cardiac troponin concentrations are observed in various clinical situations without acute coronary syndrome, and therefore physicians often find it difficult to interpret positive troponin levels. The emergence of high-sensitivity analyses has led to the accelerated diagnosis of myocardial infarction – rapid (1- and 3-hour) diagnostic algorithms; however, additional problems have appeared due to low specificity. The review describes the reasons for the elevated concentration of cardiac troponins without myocardial infarction. The mechanisms for elevation of cardiac troponins and their diagnostic value in various nosological entities are discussed. Part 1 of the paper considers the mechanisms for elevation of troponins and their diagnostic value in diseases having the clinical symptoms similar to those of myocardial infarction, which frequently causes diagnostic errors. These include pulmonary embolism, myocarditis, and Takotsubo syndrome.

Keywords: 
cardiology
cardiac troponins
acute coronary syndrome
pulmonary embolism
myocarditis
Takotsubo syndrome



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