How to interpret cardiac biomarkers in children?

Claire McGinn, Thomas Waterfield, Gareth McKeeman, Louise Morrison, Sinead Callaghan, Chris Watson, Frank A. Casey

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Abstract

Cardiac biomarkers are used as first-line diagnostic tools in suspected myocardial injury and heart failure in adult patients. Their use in paediatric patients has been limited by variability caused by age, gender and the presence of an underlying congenital cardiac condition. There are established reference ranges for both NT-proBNP and troponin in healthy children, but these cannot be applied to all paediatric patients because of limited large studies focusing on children with congenital heart disease and/or cardiomyopathy. This article will focus on the pathophysiology of myocardial injury and heart failure in children and the subsequent cardiac biomarker correlation. It will explain how to interpret the biomarker assay levels obtained for both troponin and NT-proBNP and highlights the importance of a clear clinical question prior to requesting a cardiac biomarker assay level. Clinical cases outline scenarios that may prompt consideration of biomarker analysis in children and aims to equip the reader with an understanding of how to interpret the results.

Original languageEnglish
Article number324466
JournalArchives of Disease in Childhood: Education and Practice Edition
Early online date22 Nov 2022
DOIs
Publication statusPublished online - 22 Nov 2022

Bibliographical note

Publisher Copyright:
© 2022 Author(s). Published by BMJ.

Keywords

  • Cardiology
  • Child Health
  • Paediatrics

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