Template:Elevated troponin DDX

Elevated Troponin

True Positive

• Occlusive myocardial infarction
  • STEMI
  • NSTEMI

False (Non-CAD) Positives

• Pericarditis
• Myocarditis
• PE
• CHF
• Sepsis
• Dissection
• Arrhythmias
• CVA
• SAH
• Burns
• Renal failure
  • Assume true positive until proven otherwise
• ESRD
  • 86% elevated predialysis in troponin-T
  • 6% elevated predialysis in troponin-I
    • no difference in post-MI troponin-I clearance rate in ESRD vs. normal GFR
• Cardioversion
• Cardiotoxic medications
• Amyloidosis
• Rheumatoid Factor
• Heterophilic antibodies
• Apical ballooning syndrome
• Cardiac procedures (surgery, ablation, pacing, stenting)
• Extreme exertion