Troponiinia

Troponiinia, or troponin elevation, refers to raised levels of cardiac troponin in the blood, most commonly troponin I or troponin T. Troponin is a regulatory protein complex in cardiac muscle, and its cardiac-specific isoforms are released into the bloodstream when heart muscle cells are damaged. High-sensitivity immunoassays can detect small increases, allowing earlier recognition of injury.

In clinical practice, troponin elevation is a central biomarker in the assessment of suspected acute coronary syndrome (ACS). An elevated troponin level alone does not prove a myocardial infarction; diagnosis requires a compatible clinical picture, such as ischemic symptoms or ECG changes, and a dynamic rise or fall in troponin on serial testing. The 99th percentile upper reference limit is commonly used as a threshold, with a rising or falling pattern supporting acute injury.

Common causes of troponiinia include acute myocardial infarction, myocarditis, heart failure, pulmonary embolism, severe hypertension, arrhythmias, renal failure, and systemic illnesses such as sepsis. Mild elevations can also occur after strenuous exercise or certain medical procedures. Chronic conditions, particularly kidney disease, can lead to persistently elevated troponin without an acute infarction.

Interpretation should consider pretest probability and clinical context, as troponin is a marker of myocardial injury rather than a specific diagnosis. False positives can arise from assay interference or less specific reactions in some settings. Management focuses on identifying the underlying cause and monitoring troponin trends alongside clinical and imaging findings.