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Subtypes of troponin (cardiac I and T) are sensitive and specific indicators of heart muscle damage . They are measured in the blood to differentiate between unstable angina and myocardial infarction (heart attack) in people with chest pain or acute coronary syndrome.
Differential diagnosis of troponin elevation includes acute infarction, severe pulmonary embolism causing acute right heart overload, heart failure, myocarditis. Troponins can also calculate infarct size but the peak must be measured in the 3rd day. After myocyte injury, troponin is released in 2–4 hours and persists for up to 7 days.
Dr. Jeremy London is a heart surgeon and a heart attack survivor. He operates on diseased hearts, but like many people, he ignored his own symptoms of a coronary artery blockage until it became an ...
When calcium binds to the troponin C, it causes conformational changes which lead to dislocation of troponin I. Afterwards, tropomyosin leaves the binding site for myosin on actin leading to contraction of muscle. The letter I is given due to its inhibitory character. It is a useful marker in the laboratory diagnosis of heart attack. [2]
The level of the troponin, as well as a change over time, are useful in measuring and diagnosing or excluding myocardial infarctions, and the diagnostic accuracy of troponin testing is improving over time. [72] One high-sensitivity cardiac troponin can rule out a heart attack as long as the ECG is normal. [83] [84]
Troponin T binds to tropomyosin and helps position it on actin, [2] and together with the rest of the troponin complex, modulates contraction of striated muscle. [3] The cardiac subtype of troponin T is especially useful in the laboratory diagnosis of heart attack because it is released into the blood-stream when damage to heart muscle occurs. [4]