Table 1.
Causes of troponin elevation. Modified from Thygesen et al. [11].
| Main Phatophysiological Mechanism | Pathology |
|---|---|
| Injury related to primary myocardial ischemia | Plaque rupture |
| Intraluminal coronary artery thrombus formation | |
| Injury related to supply/demand imbalance of myocardial ischemia |
Tachy-/brady-arrhythmias |
| Aortic dissection or severe aortic valve disease | |
| Hypertrophic cardiomyopathy | |
| Cardiogenic, hypovolemic, or septic shock | |
| Severe respiratory failure | |
| Severe anemia | |
| Hypertension with or without LVH | |
| Coronary spasm | |
| Coronary embolism or vasculitis | |
| Coronary endothelial dysfunction without significant CAD | |
| Injury not related to myocardial ischemia | Cardiac contusion, surgery, ablation, pacing, or defibrillator shocks |
| Rhabdomyolysis with cardiac involvement | |
| Myocarditis | |
| Cardiotoxic agents, e.g., anthracyclines, herceptin | |
| Multifactorial or indeterminate myocardial injury |
Heart failure |
| Stress (Takotsubo) cardiomyopathy | |
| Severe pulmonary embolism or pulmonary hypertension | |
| Sepsis and critically ill patients | |
| Renal failure | |
| Severe acute neurological diseases, e.g., stroke, subarachnoid | |
| hemorrhage | |
| Infiltrative diseases, e.g., amyloidosis, sarcoidosis | |
| Strenuous exercise |