An Elevated Value of Troponin I, Troponin T, CK-MB, and/or Myoglobin

Differential Diagnosis

Troponin I or T is now widely used over other markers for acute MI in the absence of other markers.

Any elevation can indicate myocyte damage; interpret results with defined institutional cutoffs for myocardial infarction.

Suggested Additional Lab Testing

Appropriate follow-up testing with troponin level.

• Test as appropriate to rule out causes of increased troponin not caused by cardiac ischemia.

Clinical considerations

• If ECG is abnormal in the presence of positive markers, this is strongly indicative for AMI.

• If ECG is normal or shows a pattern not indicative for AMI with a suggestive clinical picture for MI, do serial testing for troponin pressure sensation within the chest with appropriate radiation of pain, which is suggestive of AMI.

• Rule out other potential causes of an elevated troponin.

• Perform ECG.

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