Possible non-acute coronary syndrome causes of troponin elevation (bold: important differential diagnoses)
• Chronic or acute renal dysfunction
• Severe congestive heart failure – acute and chronic
• Hypertensive crisis
• Tachy- or bradyarrhythmias
• Pulmonary embolism, severe p ulmonary hy pertension
• Inflammatory diseases, e.g. myocarditis
• Acute neurological disease, including stroke, or subarachnoid haemorrhage
• Aortic dissection, aortic valve disease or hypertrophic cardiomyopathy
• Cardiac contusion, ablation, pacing, cardioversion, or endomyocardial biopsy
• Hypothyroidism
• Apical ballooning syndrome (Tako-Tsubo cardiomyopathy)
• Infiltrative diseases, e.g. amyloidosis, haemochromatosis, sarcoidosis, sclerodermia
• Drug toxicity, e.g. adriamycin, 5-fluorouracil, herceptin, snake venoms
• Burns, if affecting >30% of body surface area
• Rhabdomyolysis
• CriticallESC Guidelines for the management of acute
ESC Guidelines for the management of acute coronary syndromes in patients presentingwithout persistent ST-segment elevation. 2011
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