**9. Conclusion**

In this review, we have identified the need for a gold standard cardiac examination to be performed in all ruminant cases where cardiac disease is suspected. We have also re-emphasised the ability for echocardiogram and pericardiocentesis to provide a diagnosis of TP. These methods are also required to help review and evaluate the use of cTnI as a possible indicator of prognosis in TRP with TP. We highlight the need to correlate serum cTnI levels and other cardiac biomarkers to the severity of myocardial damage present, and the correlation of such values to the stage of TP via findings on echocardiogram, necropsy examination and histopathology. There is also a need to carry out further research into serum cTnI in larger cohorts of cattle over a significant time-frame starting from initial TRP through to severe TP cases, in order to validate its use as a commercially viable and dependable parameter. In order to do this, specific cut off values for disease level and severity, and a normal cattle cTnI reference range still needs to be defined.

However, this review suggests that with further investigation and if proven to be reliable, serum cardiac biomarkers such as cTnI have the potential to revolutionise diagnosis of traumatic pericarditis in cattle.
