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Overview

Troponin I

Normal value range
Pathophysiology
Special considerations
Elevations in lab values

Nursing Points
General

Normal value range

Typically, less than 0.035 ng/mL or less
Can vary among institutions
Has to be greater than the 99th percentile

Pathophysiology

Troponin is released during myocardial cell damage
Decreased perfusion causes myocardial cell damage
Causes of myocardial cell damage

Myocardial infarction
Demand ischemia

Cardiogenic

ACS

Noncardiogenic

Sepsis
Renal failure
Extreme exercise

Special considerations

Submitted in green top tube
Value peak

Detection 6-12 hours after acute injury
Peaks 24 hours after injury
Can stay elevated for a week

Knowing patient history is critical

Increased values

Any elevated value is typically considered critical
Acute elevations warrant immediate investigation

Typically PCI (percutaneous coronary intervention)/Angiography and EKG to rule out MI or ACS (acute coronary syndrome)

Other elevations

CABG
Extreme exercise
End Stage Renal Failure

Assessment

Assess for:

Acute chest pain
Symptoms of MI

Nausea
Vomiting
Angina in any form
Reflux (especially in women)

Therapeutic Management

EKG
Angiography or PCI
Management of non-cardiogenic etiology

Nursing Concepts

Lab Values
Perfusion

Patient Education

Educate patient on keeping history of elevated levels or cardiac disease for future reference
Educate patient on duration of elevated troponin levels, post injury

More episodes from Lab Values Podcast (Nursing Podcast, normal lab values for nurses for NCLEX®) by NURSING.com (NRSNG)