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

Clinical Cases: Serial Monitoring Differentiates Acute and Chronic hs-TnT Elevation

Serial monitoring differentiates acute and chronic hs-TnT elevation

What is the diagnosis of this case?


Unstable angina

(and heart failure following a previous anterior wall infarction)

Typical angina pectoris, although an elevated cTnT-hs level was found at admission. In order to distinguish between acute and a chronic cTnT-hs elevation; troponin levels must be monitored with serial testing. The changes in troponin levels are below 50 % (<7 ng/L). In this case the small changes in concentration are indicative of chronic myocardial damage. This is consistent with the magnetic resonance imaging (MRI), indicating a previous myocardial infarction of the anterior wall.


There is no rise or fall in cTnT-hs values needed for AMI diagnosis.

  1. Clinical Chemistry, https://doi.org/10.1373/clinchem.2011.171827

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