Pediatr. praxi. 2024;25(5):286-293 | DOI: 10.36290/ped.2024.055

Troponin elevation in children

MUDr. Hana Pudichová¹, doc. MUDr. Jan Pavlíček Ph.D., MHA^{1, 2, 3}, MUDr. Bořek Trávníček, MBA^{1, 2}, MUDr. Markéta Nowaková, MBA^{1, 2}, MUDr. Miroslava Burešová^{1, 2}, MUDr. Jiří Pudich^{2, 4}

¹ Klinika dětského lékařství, Fakultní nemocnice Ostrava, Ostrava

² Lékařská fakulta, Ostravská univerzita, Ostrava

³ Centrum biomedicínského výzkumu, Fakultní nemocnice Hradec Králové

⁴ Interní a kardiologická klinika, Fakultní nemocnice Ostrava, Ostrava

Troponins T and I are important biomarkers of cardiac damage, the levels of which are currently determined by highly sensitive diagnostic kits. In the adult population, troponin is of central importance in the diagnosis of acute coronary syndrome. In pediatrics, the reasons for troponin testing are different, with acute myocarditis of infectious or non-infectious aetiology being the most common indication. Troponin levels can rule out or to a great degree confirm this disease and correlate with its severity; the levels, however, can not reliably predict late myocardial dysfunction. Still, troponin, along with natriuretic peptides, can be used in the monitoring of cardiomyopathies to predict complications and prognosis. In congenital heart disease, troponin is most commonly used to evaluate the postoperative course. In the context of diagnosing myocardial ischemia in children, troponin is important when coronary artery pathology is suspected in Kawasaki disease, post-COVID syndrome, congenital anomalies, or after surgical coronary interventions. Other possible indications for troponin testing include chest trauma, electric shock, sepsis, renal failure, carbon monoxide intoxication, arrhythmias, cardiotoxic therapy, or endocrine and neuromuscular diseases. It is always necessary to know the normal values for the used diagnostic kit and the type of troponin, to assess the dynamics of values over time and to correlate the laboratory results with clinical examination and other diagnostic methods.

Keywords: troponin T, troponin I, myocarditis, cardiomyopathy, PIMS-TS, cardiotoxicity, congenital heart defects.

Accepted: October 21, 2024; Published: November 15, 2024  Show citation