TABLE 5.
Myocardial Injury Differential
| Myocardial Injury: Defined as at Least 1 ng/L Above the 99th Percentile URL | |||
|---|---|---|---|
| Acute Myocardial Injury (Rising and/or Falling Cardiac Troponin) |
Chronic Myocardial Injury (Stable Elevation in Cardiac Troponin) |
||
| Cardiovascular Causes | Noncardiovascular Causes | Cardiovascular Causes | Noncardiovascular Causes |
| Acute myocardial infarction (type 1–5 MI) | Sepsis | Stable coronary artery disease | Chronic renal failure |
| Hypertensive emergency/urgency | Acute renal failure | Chronic heart failure | Skeletal myopathies |
| Acute heart failure | Noncardiac surgery | Uncontrolled arrhythmias | Cardiotoxic medications |
| Pulmonary embolism | Critical illness | Hypertension | |
| Acute aortic syndrome | Rhabdomyolysis | Valvular heart disease | |
| Cardiac surgery | Cardiotoxic medications | Cardiomyopathies | |
| Cardiac intervention, including PCI, ablations, valve replacements, cardioversion/defibrillation, endomyocardial biopsy | Stroke | Pulmonary hypertension | |
| Acute valvular heart disease | Extreme exercise | Left ventricular hypertrophy | |
| Stress cardiomyopathy | False-positive result | ||
| Cardiac contusion | |||
| Myocarditis/myopericarditis/endocarditis | |||
| Arrythmias | |||
PCI = percutaneous coronary intervention; URL = upper reference limit