Common examples of underlying causes of non-MI troponin elevation include: Some underlying conditions can cause a type 2 MI or a non-MI troponin elevation depending on the clinical context. Januzzi, J.L., Jr, et al., High-Sensitivity Troponin T Concentrations in Acute Chest Pain Patients Evaluated With Cardiac Computed Tomography. 261266, 2002. Combining a doubling of the baseline myoglobin level at two hours after symptom onset with an abnormal myoglobin test at six hours after symptom onset increases the sensitivity to 95 percent at six hours.25. Physical exam did not reveal evidence of heart failure, wheezing, or crackles. demonstrated that esophageal acid stimulation in patients with documented CAD on angiogram resulted in typical chest discomfort and a significant reduction in coronary blood flow as measured by intracoronary Doppler in 9 of 14 (64%) patients [10]. Causes of Right-Side Chest Pain In a recent study examining 69,299 patients admitted through the emergency department(ED), 48% had their cTn measured. Troponin elevations tend to be mild, with more indolent (or even flat) troponin trajectories. Differentiating acute coronary syndrome from noncardiac chest pain is the primary diagnostic challenge. In general, renal failure in the absence of symptoms/signs of ischemia is best classified as a non-MI troponin elevation. In: Goldman-Cecil Medicine. F. Guarner, Lazaro, Gascon, Royo, Eximan, and Herrero, Map of Digestive Disorders and Diseases, World Gastroenterology Organization, 2008, http://www.worldgastroenterology.org/assets/downloads/pdf/wdhd/2008/events/map_of_digestive_disorders_2008.pdf. In a study by Dobrzycki et al., 50 patients with angiographically proven CAD underwent simultaneous continuous ECG and esophageal pH monitoring for 24 hours to assess for ST-segment depression episodes and total duration of ischemic episodes [11]. Epub 2017 Aug 1. A Case of Elevated Troponin I Level After Packed Red Blood Cell Transfusion With Normal Coronary Angiography. Bouzas-Mosquera A, Peteiro J, Broulln FJ, Constanso IP, Rodrguez-Garrido JL, Martnez D, Yez JC, Bescos H, lvarez-Garca N, Vzquez-Rodrguez JM. Your email address will not be published. A comprehensive literature search was conducted from November 11, 2017, to May 1, 2020, encompassing randomized and nonrandomized trials, observational studies, registries, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, Agency for Healthcare