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Troponin (cTnI / hs-cTn)

Cardiac
Normal range
< 0.04 ng/mL (conventional; hs assays lab-specific)

SI: lab-specific

Critical high: any significant rise/fall pattern

☎ When to call

Any new elevation with chest pain/ECG changes — this is an MI pathway activation, not a routine result. Rising serial troponins: call with the trend and current symptoms.

What you do
  • Serial draws on time — the PATTERN diagnoses MI, a single value doesn't
  • New elevation: 12-lead ECG now, compare to prior; chest pain assessment
  • Renal patients run chronically elevated — the delta matters, not the absolute
Causes of HIGH troponin
MI (rise-and-fall pattern)Demand ischemia (sepsis, tachyarrhythmia)Renal failure (chronic elevation)PE, myocarditis
Causes of LOW troponin
Normal — good
Source: Pagana, Mosby's Manual of Diagnostic and Laboratory Tests, 7th ed.; AHA/ACC chest pain guidelineReference only — verify against your facility's policy.

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