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QJM Advance Access originally published online on April 8, 2005
QJM 2005 98(5):365-371; doi:10.1093/qjmed/hci055
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© The Author 2005. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Commentary

Pitfalls and problems of relying on serum troponin

C.E. Burness, D. Beacock and K.S. Channer

From the Department of Cardiology, Royal Hallamshire Hospital, Sheffield, UK

Address correspondence to Professor K. Channer, Dept Cardiology, Royal Hallamshire Hospital, Glossop Rd, Sheffield S10 2JF. email: kevin.channer{at}sth.nhs.uk

Cardiac troponin (cT) is released after myocardial damage. In the appropriate clinical setting, a measured elevation of cT can increase the diagnostic rate of myocardial infarction and acute coronary syndrome. Elevations of cT, however, can occur in a wide variety of other clinical situations. Failure to recognize this can lead to an over-diagnosis of myocardial infarction (MI). We present clinical cases from our institution that illustrate this diagnostic problem, and review similar cases in the literature. We also discuss the implications of an erroneous diagnosis of myocardial infarction, for the patient and for the health services.


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