Tanindi Asli, Cemri Mustafa
Gazi University Faculty of Medicine, Department of Cardiology, Ankara, Turkey.
Vasc Health Risk Manag. 2011;7:597-603. doi: 10.2147/VHRM.S24509. Epub 2011 Sep 22.
Acute coronary syndromes comprise a large spectrum of clinical conditions ranging from unstable angina pectoris to acute ST-elevation myocardial infarction. Chest pain is usually the major symptom of atherosclerotic heart disease; however, it may be challenging to diagnose correctly, especially in the emergency department, because of the ambiguous way that pain is characterized by some patients. Cardiac troponins are sensitive and specific biomarkers used in the diagnosis of myocardial infarction that are released into the bloodstream when cardiac myocytes are damaged by acute ischemia or any other mechanism. They are the cornerstone for the diagnosis, risk assessment, prognosis, and determination of antithrombotic and revascularization strategies. However, troponin elevation indicates the presence, not the mechanism, of myocardial injury. There are many clinical conditions other than myocardial infarction that cause troponin elevation; thus, the physician should be aware of the wide spectrum of disease states that may result in troponin elevation and have a clear understanding of the related pathophysiology to effectively make a differential diagnosis. This review focuses on causes of troponin elevation other than acute coronary syndromes.
急性冠状动脉综合征包括从不稳定型心绞痛到急性ST段抬高型心肌梗死等一系列临床情况。胸痛通常是动脉粥样硬化性心脏病的主要症状；然而，由于一些患者描述疼痛的方式不明确，正确诊断可能具有挑战性，尤其是在急诊科。心肌肌钙蛋白是用于诊断心肌梗死的敏感且特异的生物标志物，当心肌细胞因急性缺血或任何其他机制受损时，它们会释放到血液中。它们是诊断、风险评估、预后以及确定抗栓和血运重建策略的基石。然而，肌钙蛋白升高表明存在心肌损伤，但不能说明其机制。除心肌梗死外，还有许多临床情况会导致肌钙蛋白升高；因此，医生应了解可能导致肌钙蛋白升高的广泛疾病状态，并清楚了解相关病理生理学，以便有效地进行鉴别诊断。本综述重点关注急性冠状动脉综合征以外导致肌钙蛋白升高的原因。
