Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Case Report

Volume 7, Number 10, October 2015, pages 820-824

Elevated Troponin I in the Absence of Coronary Artery Disease: A Case Report With Review of Literature

Tables

Table 1. Additional Diagnostic Criteria (Apart From Cardiac Biomarkers) for the Diagnosis of Myocardial Infarction as per the 2012 Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction [1]
 
Symptoms of ischemia
New significant ST/T wave changes or new left bundle branch block on ECG
Pathological Q waves on ECG
Imaging evidence of myocardial wall motion abnormalities
Intra-catheterization or post-mortem evidence of coronary thrombus

 

Table 2. Types/Mechanism of Myocardial Infarction [1]
 
IPrimary myocardial ischemia, i.e. plaque rupture, thrombus formation
IISupply/demand ischemia, i.e. vasospasm, hypotension, arrhythmia, severe anemia
IIIInjury without ischemia, i.e. myocarditis, cardiac contusion
IVMultifactorial, i.e. heart failure, renal failure

 

Table 3. Causes (Non-Acute Coronary Syndrome) of Elevated Troponin by System [9-12]
 
CardiovascularRespiratory
  Aortic dissection  Pulmonary embolism
  Arrhythmia  ARDS
  Heart failureInfectious/immune
  Endocarditis/myocarditis/pericarditis  Severe sepsis/septic shock
  LVH  Critical illness
  Infiltrative disease  TTP
  Stress cardiomyopathyGastrointestinal
Mechanical injury  Severe GI bleeding
  Blunt trauma/contusionCNS
  Cardiac surgery/angioplasty/ablation/cardioversion  Ischemic/hemorrhagic stroke
  CPR  Severe head trauma
Musculoskeletal/skinRenal
  Rhabdomyolysis  Chronic kidney disease
  Extensive burnsOther
Toxins/drugs  Strenuous exercise
  Cocaine
  Cardiotoxic chemotherapy
  Cyanide intoxication
  Carbon monoxide poisoning
  Amphetamines
  Scorpion/snake/box jellyfish venom

 

Table 4. Causes of False-Positive Troponin Elevations [12, 17]
 
Heterophilic antibodies
Rheumatoid factor
Fibrin clots
Microparticles in the specimen
Immunocomplex formation
Analyzer malfunction