Dr Evangelos Giannitsis
Cardiologist, Medical Director of Chest Pain Unit, University Hospital of Heidelberg, Germany

Clinical Cases: Elevations of hs-TnT in Non-cardiac Conditions

Elevations of hs TnT in non-cardiac conditions

What is the diagnosis of this case?


Acute pulmonary embolism

This patient presents the typical clinical features and has an indicative history following a prolonged flight. Typical ECG changes with sinus tachycardia, SI-QIII type, right bundle-branch block are observed. The angiographic CT scan (256-slice CT) shows multiple thromboembolic events (red arrows) bilaterally. The cTnT-hs levels display an acute kinetic profile with a rapid rise followed by a fall. The clinical context is the key element to consider for a differential diagnosis of acute non-STEMI.


The clinical features do not suggest a diagnosis of AMI.

  1. Agewall S, Giannitsis E, Jernberg T, Katus H. Troponin elevation in coronary vs. non-coronary disease. Eur Heart J. 2011; 32: 404–11

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