Cardiac disease: Coronary or not?

Acute myocardial Infarction (AMI) is a major cause of death and disability. Worldwide, one in eight patients die of an ischemic heart disease. Its rapid and accurate diagnosis is critical for the initiation of effective evidence based medical management, including early revascularization, but is still an unmet clinical need. The gradual implementation of high-sensitive cardiac troponins (hs-cTnT) in clinical practice has helped clinicians to detect and treat patients with acute myocardial infarction earlier than with conventional assays. But, high-sensitive assays have also caused considerable confusion among clinicians as to the interpretation of, in particular, minor elevations. Now, many patients with cardiovascular disorders such as tachyarrhythmia, hypertensive urgency or heart failure are also "troponin positive" with the high-sensitive assays, in the absence of a coronary obstruction.