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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.
A person who recently had a myocardial infarction has areas of damaged heart muscle and elevated cardiac troponin levels in the blood. [15] This can also occur in people with coronary vasospasm, a type of myocardial infarction involving severe constriction of the cardiac blood vessels. After a myocardial infarction troponins may remain high for ...
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]
Troponin I, cardiac muscle is a protein that in humans is encoded by the TNNI3 gene. [ 5 ] [ 6 ] It is a tissue-specific subtype of troponin I , which in turn is a part of the troponin complex . The TNNI3 gene encoding cardiac troponin I (cTnI) is located at 19q13.4 in the human chromosomal genome.
Cardiac muscle troponin T (cTnT) is a protein that in humans is encoded by the TNNT2 gene. [5] [6] Cardiac TnT is the tropomyosin-binding subunit of the troponin complex, which is located on the thin filament of striated muscles and regulates muscle contraction in response to alterations in intracellular calcium ion concentration.
Blood pressure may be elevated or decreased, and the pulse can become irregular. [8] [9]: 1444 If heart failure ensues, elevated jugular venous pressure and hepatojugular reflux, or swelling of the legs due to peripheral edema may be found on inspection.
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]
This is a shortened version of the seventh chapter of the ICD-9: Diseases of the Circulatory System. It covers ICD codes 259 to 282. The full chapter can be found on pages 215 to 258 of Volume 1, which contains all (sub)categories of the ICD-9. Volume 2 is an alphabetical index of Volume 1.