Abstract
The use of cardiac troponins (cTn) in lieu of creatine kinase to diagnose myocardial infarction (MI) has allowed us to detect even the smallest myocardial damage. Recently the use of high-sensitivity assays to measure even the tiniest myocardial injuries has led to a substantial increase in the diagnosis of MI. However, the specificity of such tests has been compromised and false positive results are rising. Clinicians should be aware that elevated cTn may be encountered in a variety of conditions of non-thrombotic cardiac damage, but also in a plethora of non-coronary diseases and laboratory interferences. These caveats are herein overviewed and an algorithm is proposed of a step-wise approach to using cTn measurement to triage and manage patients with suspected acute coronary syndromes.
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