About the Troponin Toolbox
Welcome to the Troponin Toolbox
The Troponin Toolbox is an educational tool that helps residents and fellows work through myocardial infarction, troponin, and acute coronary syndromes. It is not certified for clinical use and is not a substitute for clinical judgment. Patients with ST-elevation MI, shock, or other life-threatening conditions need immediate care, not this tool. Please visit our other resources at www.troponin.org.
Why this site exists
Troponin is one of the most heavily ordered tests in hospitals, including in patients without anginal symptoms . A mildly raised value in a patient with no symptoms can lead to downstream testing, radiation exposure, misdiagnosis, and financial burden . This site exists to help clinicians turn a troponin result into a sound clinical judgment.
Three ideas behind it
1. Probability, not just positive or negative. Positive and negative predictive values and likelihood ratios are rarely at hand at the bedside, and the usual shortcut of pattern recognition is open to cognitive bias. The probability primer and the test characteristics tool put these numbers where you can see them.
2. The history and exam matter more, not less. Mild elevations are now common with high-sensitivity assays, so telling injury without ischemia from injury with ischemia depends on what only the bedside can provide: the history, the exam, and the ECG. The ECG checker and the UDMI classifier walk through those steps.
3. Special populations need special care. Troponin behaves differently in patients on immunotherapy, with congenital heart disease, or with reduced kidney function, and the meaning of a static versus a rising value changes with them. See the etiologies, the biochemistry behind interference, and the journal club.
Where things are
| If you want to | Go to |
|---|---|
| Classify a case under the 5th UDMI | UDMI classifier |
| Check ST-elevation and occlusion-equivalent ECG patterns | ECG criteria checker |
| See how timing changes a troponin result | Troponin kinetics |
| Estimate the value of a finding or a test | Bayes interpreter and Probability primer |
| Learn the vocabulary and the 4th to 5th changes | Terminology and crosswalk |
| Find causes of a raised troponin | Etiologies |
| Understand assays, limits, and interference | Troponin biochemistry |
| Read the key papers | Journal club |
| See the two documents this site is built around | The guidelines |
| Look up a treatment recommendation | 2025 ACC/AHA guideline |
| Learn who contributed, and how to cite the site | Acknowledgments and citing |
More about this site
- Using it safely: who it is for, what it is not for, and what happens to the values you enter.
- Where each tool gets its evidence: the source behind every tool, with citations.
- Acknowledgments and citing: the people who contributed, and how to cite the site.