The Third Universal Definition of Myocardial Infarction gave a differential diagnosis for an increase in serum troponin.
Mechanisms for an elevated serum troponin include:
(1) primary myocardial ischemia with a lesion within one or more coronary arteries
(2) myocardial ischemia related to supply and/or demand imbalance
(3) myocardial injury not due to myocardial ischemia
(4) multifactorial
(5) indeterminate
Coronary artery conditions:
(1) plaque rupture within a coronary artery
(2) thrombus within a coronary artery
(3) coronary embolus
(4) coronary vasculitis
(5) coronary artery vasospasm
(6) coronary endothelial dysfunction
Other cardiovascular conditions
(1) arrhythmias (brady, tachy)
(2) aortic dissection
(3) severe aortic valve disease
(4) hypertrophic cardiomyopathy
(5) shock (cardiogenic, septic, hypovolemic, etc)
(6) hypertension
(7) cardiac contusion or trauma
(8) cardiac surgery
(9) ablation or pacing
(10) defibrillator shocks
(11) rhabdomyolysis affecting cardiac myoctes
(12) myocarditis
(13) cardiotoxic drugs or chemicals
(14) heart failure
(15) Takotsubo cardiomyopathy
(16) cardiac amyloidosis
(17) cardiac sarcoidosis
(18) other infiltrative disorders of the heart
(19) strenuous exercise
Extracardiac conditions:
(1) severe respiratory failure
(2) severe anemia
(3) severe pulmonary embolism
(4) pulmonary hypertension
(5) renal failure
(6) severe acute neurological disease (stroke, subarachnoid hemorrhage)
