Troponin levels high?
I went to A&E with chest pain they gave me a blood test and my troponin was 60 they took it again 2 hours later they said it had gone up to 85. I was told I had heart attack due to this blood test but in the morning cardiologist said no and some people just have high troponin levels naturally or it may be due to my long standing high blood pressure I am 34 is this true or is it likely I have had a heart attack of some kind and I should get a second opinion
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Troponin usually is a MI marker
Well troponin is only one way to determine MI. The problem is this. Troponin assays have gotten more sensitive but in so doing then the rise in false positives have gone up to 20%. The increased sensitivity means that one can rule out or rule in an MI within 3 hours vs the old assays of 6 hours.
The rise and fall and having one troponin level over the 99 percentile reference range value is included in the diagnostic criteria of AMI. If the person presents to the ED with ischemic symptoms and ECG findings of STEMI or a Q wave MI then troponin is not theoretically needed. I take it your ECG was not diagnostic.
With the sensitive troponin in use today we look at the change (deltas). There’s a 20% false positive rate because the assay is so sensitive and can detect myocardial damage from many other sources. The rise and fall in relation to symptoms is important in evaluation vs chronic elevations associated from other cause.
We don't have all the information in front of us and so it is impossible to render a well informed opinion but based on the information you presented then a second opinion is in order or at least a follow up with a doctor at the very least.
That s interesting. Of course cardiologists only focus on the heart. What your cardiologist didn t mention is that troponin is also an indicator of kidney damage, which can occur from high blood pressure. You would need to have troponin levels measured again several days after the initial tests to see if the levels are similar. If troponin has dropped significantly, then you would suspect that an acute event such as a heart attack may have occurred. If the levels are still high, it would be a good idea to see a doc to have your kidney function evaluated.
It also seems odd that the cardiologist didn t recommend some type of follow-up evaluation for your heart.
Don't ever believe what a cardiologist tells you always get advice from the morons on Yahoo instead.
Yes, it's true that some people have naturally higher troponin levels and that it might be due to your high blood pressure, but that doesn't mean you shouldn't also go get a second opinion.