Troponin I (cTNL) Lab Values

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