The American College of Cardiology and European Society of Cardiology have redefined myocardial infarction as a rise of troponin above the laboratory reference range (99^th percentile of a reference control group), in conjunction with typically ischaemic symptoms, a history of recent coronary intervention, the development of Q waves or dynamic ST-segment changes.¹

Troponin concentrations are highly specific for myocardial necrosis, but disease states other than myocardial infarction can cause elevated plasma levels (table 1).² It is our impression that there has been widespread misinterpretation of the new definition, and troponin concentrations are frequently assumed to reflect myocardial infarction without corroborative evidence from the patient’s history or electrocardiogram (ECG). We present an illustrative case of elevated troponin concentrations following minor chest trauma. …