Troponin Pathway

Target audience: Secondary care - acute hospital sites
Patient group: All adult patients (Age >15) with chest pain

HSTnT

Other cardiac causes of raised HSTnT	Non cardiac causes of raised HSTnT
Severe/prolonged tachyarrythmia	Critical illness e.g. sepsis, burns, shock
Heart failure/myo-pericarditis	PE
Stress induced cardiomyopathy (Takotsubo)	Acute exacerbation of COPD
Defibrillation	Intracranial haemorrhage/stroke
Recent cardiac procedure	End stage renal failure
Aortic dissection	Rhabdomyolysis
Hypertensive crisis	Infiltrative disease e.g. sarcoidosis, amyloidosis/haemochromatosis
Coronary spasm	Hyper/hypothyroidism
Cardiac contusion	Strenuous exercise
	Seizures
	Drug toxicity/poisoning

References

1) Byrne RA, Rossello, Coughlan JJ, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J 2-23;44:3720-6 Link https://doi.org/10.1093/eurheartj/ehad191

2) Overview | High-sensitivity troponin tests for the early rule out of NSTEMI | Guidance | NICE

Last reviewed: 18/03/2025

Next review date: 18/03/2028

Author(s): Dr Nicola Moultrie, Consultant in Emergency Medicine, University Hospital Monklands.

Version: 3

Co-Author(s): Dr Charlotte Grain, Dr Tanya Baron, Dr David Carrick, Neil Syme, Jacqueline McGuire.

Approved By: Acute Division

Reviewer name(s): Dr Gordon McNeish, Associate Medical Director for Unscheduled Care.

Document Id: July 2025

Troponin Pathway