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Cardiac biomarkers are endogenous substances released into the bloodstream when the heart muscle is damaged or stressed.[1] Measurement of these biomarkers is used to help diagnose, assess risk, and manage acute coronary syndrome (ACS), a potentially life-threatening condition characterized by the sudden onset of persistent pain in the chest, one or both arms, shoulders, stomach, or jaw, shortness of breath, nausea, sweating and dizziness.[2] Cardiac enzymes have been in use since the mid-20th century in evaluating patients with suspected acute myocardial infarction (MI). The biomarkers used back then are not clinically relevant today as more sensitive and specific biomarkers have replaced them.[3] Troponins are the key cardiac biomarkers in modern medicine for diagnosing acute myocardial ischemia.[4] In contrast to creatine kinase (CK), which usually elevates 6 to 12 hours after arriving at the emergency department, troponins show elevation in most AMI cases within 2 to 3 hours of arrival.[5]

The correct diagnosis of AMI requires an interprofessional team of healthcare professionals that may include laboratory technologists, nurses, advanced care practitioners, and physicians. Measuring the blood levels of cardiac troponins is one of the first steps in reaching a diagnosis. Swift diagnosis of AMI is crucial, as less time from symptom onset to reperfusion therapy is vital for improved long-term outcomes of heart function.[65] The path to diagnosing AMI starts with the physician ordering a cardiac troponin blood test, the nurses drawing blood and sending it to the appropriate laboratory, and the laboratory technologists accurately measuring blood levels of cardiac troponins and posting the result on the electronic medical records.