Troponin is a protein of key importance in the functioning of skeletal and cardiac muscles. It forms part of the contractile mechanism and comprises three main subunits: troponin C, troponin I, and troponin T.
Troponin elevation
Elevation of serum troponin can occur from a number of causes and it is useful for the radiologist to have a basic understanding of this, especially when interpreting imaging findings in the context of hypertroponinemia.
Etiology
The list includes:
- cardiac causes
- acute myocardial infarction
- post cardiac surgery: open heart surgery, cardiac transplantation
- following certain cardiac procedures
- percutaneous coronary intervention (PCI)
- high frequency ablation
- external current cardioversion
- defibrillator shocks
-
cardiac failure
- acute cardiac failure
- chronic cardiac failure
- acute myocarditis
- acute pericarditis 5
- cardiotoxic chemotherapy
- direct cardiac trauma: myocardial contusion
- cardiac infiltrative conditions
- takotsubo cardiomyopathy
- non-cardiac causes
-
systemic inflammatory response syndrome (SIRS)
- etiologies including viral infections, e.g. COVID-19
- septic shock
- pulmonary embolism: may be elevated in up to half of cases 1
- strenuous exercise
- renal failure
- strokes
- chronic obstructive pulmonary disease (COPD)
-
systemic inflammatory response syndrome (SIRS)
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