Many Laboratories Lack Appropriate Reference Ranges for Children's Cardiac Troponin Tests

Cardiac troponin is a protein released into the bloodstream when heart muscle cells are injured. It is widely used in adult medicine to help evaluate suspected heart attacks and other forms of cardiac injury. Children, however, are not simply smaller adults. Troponin concentrations and their interpretation can differ according to age, the assay used and the clinical situation. Applying inappropriate reference ranges may make it more difficult for healthcare professionals to distinguish abnormal results from values that require different interpretation in pediatric patients. A raised troponin level does not automatically mean a child has had a heart attack. It can occur in other conditions involving heart-muscle injury, including myocarditis and certain severe illnesses. The findings underline the need for laboratories and hospitals to use validated, assay-appropriate pediatric reference information and interpret test results alongside symptoms, examination findings and other investigations.