Title: Interpretation of Troponin in Emergency Department

Abstract:

Patients who present with chest pain in emergency department (ED) need thorough evaluation and accurate diagnosis for proper management. There are myriad of disorders that cause chest pain. Only 20–25% of the patients presenting with chest pain suffer from acute coronary syndrome (ACS). Cardiac troponins (cTns) are frequently assessed in these patients as they are the most specific and sensitive markers for the diagnosis and prognosis of ACS. These are organ-specific, not disease-specific markers. There is a role of cTn testing in diagnosis of myocardial infarction (MI) but negative troponin does not rule out other form of ACS, i.e. unstable angina. Apart from ACS there are many other causes of elevation of cTn. Hence cTn elevation should always be interpreted in the context of clinical presentation. Since the time of its first introduction, there has been tremendous improvement in the sensitivity and analytical performance, so much so, that cTn can be detected in healthy population.