How do you approach the decision to consult Cardiology and pursue an ischemic workup for an isolated troponin elevation attributable to a non-cardiac acute illness such as sepsis or acute respiratory failure?

This decision is much more complex than can be adequately addressed in this response, based on the information given. The demographics and clinical risk factors of the patient are important in this decision, as well as the comfort of the clinician/primary care physician caring for the patient. Does ...

Most isolated troponin elevations in sepsis/acute respiratory failure represent non-ischemic myocardial injury or type 2 MI from supply-demand mismatch, and the trigger for cardiology consult/ischemic workup should be clinical evidence of ischemia, not the troponin elevation alone.

When I do involv...