What does elevated troponin level mean?
An elevated troponin is in general concerning for heart damage until proven otherwise. It can be from a heart attack due to a blockage or due to other conditions that place strain on the heart such as heart failure or critical illness. As discussed below there are other, non cardiac causes of a troponin elevation.
What level of troponin indicates heart attack?
The level of troponin that indicates a heart attack is the level above the reference range. For example if the normal reference range is listed as 0.00 – 0.40. Then 0.41 is technically positive although very weakly so, and 10 is very positive. Levels above the reference range may mean heart damage, but there are other causes also. When interpreting a troponin level it is important to know the reference range of the reporting labaratory.
What causes high levels of troponin?
Damage to the heart muscle cells are the classic cause of high troponin. There are many many other causes such as kidney disease, stroke, infection, pneumonia, critical illness and many others.
Often people are hospitalized and they go home with a copy of their blood tests, one of which is a troponin level. Recently, someone asked me whether they should be worried about a heart attack after they noticed an elevated troponin level on the blood tests listed on their discharge paperwork.
What is the normal troponin level?
A normal troponin level is that within the normal reported reference range. So if the lab says < 0.04 is normal, then 0.03 and 0.02 and 0.o01 etc. are all normal!
All About Troponin
Diagnosing a heart attack used to be relatively straight forward, or so we thought. A patient would come in with chest pain, have changes on the EKG heart tracing suggestive of a heart attack, and a number of blood tests were sent off looking at levels of markers which if positive implied heart damage. When heart muscle tissue is damaged it releases molecules in to the blood stream, levels of which are known as cardiac markers. We would put this information together and then determine that the likelihood of heart attack was high when these tests were positive. Appropriate further tests were then done.
The problem was that the blood tests (in the days before troponin levels) did not pick up every heart attack, as they were not sensitive enough. Patients who were determined to be having a heart attack would typically get tests such as a heart cath where dye is injected in to the arteries, to see if there were blockages that caused the attack. Tests like echocardiograms (ultrasounds of the heart) were done to see if there was any visible damage to the heart muscle tissue.
There is clearly a difference between heart attacks that involve a whole major artery and result in large areas of heart muscle damage versus those involving the small end of an artery with no clearly seen areas of heart muscle damage. The old blood tests (before troponin levels were discovered) in many cases did not pick up a lot of the smaller heart attacks, as they were not sensitive enough.
The Start Of A New Era – The Benefits of Using Troponin
Then in the 1990’s a blood test measuring troponin levels came in to use. Troponin is a substance is released in to the blood when heart muscle is damaged. It is incredibly more sensitive than the old markers used. It turns out that we were missing many heart attacks using just the older blood tests, (although probably not the large ones). Suddenly now that we had troponin levels, when people came with chest pain, we would send this test, and bingo:
Chest Pain + Positive Troponin Level = Heart Attack
A higher troponin level to a degree probably meant a bigger attack, but we were now sending more patients for further tests and picking up damage. In fact, just the presence of high troponin levels is a reason to immediately call a cardiologist, because the test was so sensitive it must mean heart damage right!
How to Read Your Levels
There was a problem however, although the troponin test was great in that it did not miss heart attacks, it was not specific for heart attacks alone. It was realized that many patients with critical illnesses, infections, head injuries, kidney disease …(the list goes on and on) could have an elevated troponin level which may have been linked to an indirect effect on the heart muscle (We call this a type II myocardial infarction). When these patients had heart tests however, not all of them had large obstructions or damage. This was certainly not due to complete blockage of a heart artery in the classical way we think of a heart attack. Importantly, not all these patients needed to be taken for further heart procedures. In the early days of troponin testing many of these patients did undergo further heart tests and procedures, while we figured out how to use the troponin test best.
Much research has been done in to what these elevations of troponin in the absence of obstructive heart disease mean. We know that it is not a good thing, and it may be a marker / red flag for other illnesses of problems. Importantly it needs to be interpreted in the clinical context. So now you see how a patient who is admitted to the hospital with lets say a head injury or trauma or significant infection… may have mild elevation of troponin. Depending on the clinical context, many of these patients may not need further invasive tests. Often these patients may have a stress test, and if that is normal, and the heart pumping function remains normal, we are reassured that the prognosis might be good.
Its important to note however that each case should be individualized and their risk determined appropriately ideally by a cardiologist, as of course a heart that has existing disease is of course likely to be more sensitive and result in release of troponin in result of stress to other conditions. The skill is to make sure those patients are investigated appropriately, where as those with a low risk don’t need to undergo potentially risky and invasive tests.
thank you
Thank you. Very informative.
Troponin 40553 CRP 40666 -> 14147
Would you please let me know what this result means?
Thank you
Andrea
Trophin. 0.10 .HCM.by echo.
I had a Troponin level of 6.4 and I was hospitalized immediately. What does that mean?
I also had a Troponin level of 5.5-6 last summer, I was and still am only 19… just as I got to work I had chest pain/tightness, confusion, dizziness, fatigue and all the symptoms that pointed towards a heart attack. I went through every test to see if there was damage or blocked arteries but my heart was fine, they only had two possible conclusions… 1. Cell spasm which lead to cell death and 2. An infection in my heart muscle!
My brother is in the ED right now and his traponin level is 9 & the nurse told him anything under 15 is normal. That doesn’t sound right, what do you think?
It depends on the local lab level for normal. If 9 and 15 is the level, then this may be reassuring if reported by the treating team.
You can follow our twitter at @MustafaAhmedMD
Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
I had a hs trop I of 37 and the normal range says 3-37 so should I not worry I’m assuming ?
thankyou very useful information
My mother is in the hospital now and her traponin I(ES) level is 2.517 what do you think?
Hi my Troponin was 22-82-83 does that indicate heart attack.
Is clopilet tablet a better substitute for ecospirin?
Hey my troponin 1 level was .29 what does that mean I went the other night for chest pain
Read the post NSTEMI, it should give a good answer to the question.
Dear sir. My grand mother trop1 test rizalt are 0.06 sir plz tell me normal rezalt for women.
Dear sir today My grand mother trop1 current rezalt are 0.06 sir u guide me normal rezalt for women. My mother allrady pain chast and nick aram .so tell me about this trop1 test normal rezalt.
Ask the lab for the normal range, it differs from place to place depending on the assay used.
I am hear at mayo hospital with my feiance and his level is 0.527. According to the Dr here 0.01 is normal. But of course there is different levels that are ok. I am just going by what they have told us. And because it’s high does not automatically mean heart attack. There is maltipule reasons that it could be high.
I went to the ER on July 2nd, 2017 around 3:30 am. Woke from my sleep with chest pain, dizzy when I stood up . Heart rate was 166 and my ECG showed ST diffuses. They treated me for a heart attack. Six hours later I was told I didn’t have a heart attack because my troponin was <5 and my CK total was 63. I was released. I had a stress test and an echocardiogram and passed both. My question sir is, why did the ECG suggest a heart attack?? And then I'm told no. Did I almost have a heart attack?
The good news is that the stress test and echo were normal and i’m assuming your blood test result levels were normal. Its also reassuring they released you. All this suggests you didn’t have a heart attack. The EKG findings can be explained by multiple causes, the heart rate elevation was abnormal. I suggest you follow closely with a cardiologist to reiterate the test findings.
If you are interested in information and therapy for heart disease then feel free to follow my twitter at @MustafaAhmedMD
Hello again. The cardiologist says he believes it was a bad anxiety attack. All my ecg’s since then are normal. What made my heart rate and ecg go back to normal the night of the event was a drug they gave me through in called metaprolol.
Sir,
What does Trop-T positive on the day of cardiac arrest and Trop-I negative after two days of cardiac arrest mean?
My mother was intubated and during intubation she had TRACHEA RUPTURE cardiac arrest and thereafter generalised seizures for two days.
The elevated troponin means there was evidence of possible heart strain given the seriousness of all the event. The normal reading 2 days later is very reassuring and means there was likely no primary heart related issue.
you can follow my twitter at @MustafaAhmedMD
Dear Doctor, My father Has TROP-T (QUANTITATIVE ASSAY) indicates .024. Is it something to worry. We are going for angiogram.
Sir your emai add
Hi my name is Karen I’m 28 years old I have a question .for an entire year I’ve have had chest pain that would come and go but it wasn’t until last night I woke up drenched in sweat with 200bpm and terrible chest pain difficulty breathing and dizziness ambulance took me to the hospital and once lab came back I was low on potassium so i got treated with pills and With indicative of myocardial infarction damage of 0.12 ng/ml I’m just wondering why this wasn’t explained to me by doctor all I was given was potassium pills and paper work to follow up with primary did i have a stroke? Impending cardiac arrest or heart attack ?or did I have an attack and wasn’t told I did My chest pains are still very bad please help me with some answers please
My high sensitivity troponin t level is < 6 ng/l for a female. please, do you know what this means?
My triponin last night was 0.0465 should I be worried? I had a normal ekg though.
Need to know a lot more information to even begin to comment.
Where are you located and are you accepting new patients? I have been in the hospital for 11 days in Feb and chest pains yesterday. They are just saying I am a mystery. Have tested for leukemia with negative result.
Im at Princeton Baptist Medical Center in Birmingham. Hope you have had some progress since your question.
1.5 ng/London
Went to ER feeling faint, back pain, nausea , throwing up and headache which all came on suddenly. BP WAS 150 /81. BLLOD work showed 0 on the troponion levels. 2 hrs later it was 245 . Next test 340 next text test 355. Went to cath lab. No bloxkag so they ruled out mild heart attack which they were telling me all along.that that was what was happening.they said it was probably vaso spasms gave me more medications to go home on. So my question. Since high levels of troponion are indication of heart trauma is this something that might continue to happen? do I really need muscle spasm meds when should I be concerned?
I’m a patient, not a dr. Ask your doctor about Prinzmetal’s Angina, which is coronary artery vasospasms. The spasm can temporarily block the artery (picture a garden hose squeezed shut), which can cause a heart attack. It’s rare for Prinzmetal’s to cause a heart attack, but it happens. If you do have Prinzmetal’s, you would likely be out on isosorbide mononitrate (long acting nitroglycerine), a calcium channel blocker, and sublingual nitroglycerine for when the spasms happen.
Again, I’m not a dr, but a Prinzmetal’s patient who has had a heart attack (NSTEMI). Good luck.
p.s. your ER discharge papers probably advise you to schedule a follow up appointment. Find a cardiologist and make that appointment, making sure to refer to your ER visit and vasospasms.
Hi, my troponin level is 340. Does this mean i havr had a heart attack
My Troponin-T is 0.006ng/ml . what does it mean?
Need Urgent Help!
Today I tested my father High sensitive Tropoinin -I which are is 4612.9 pg/ml, due to constipation he didn’t stayed in hospital. What should I do?
Please help and suggest!
Thakns
Go see a medical provider and seek opinion.
i went to the er for alergic reaction to tree nuts and the nurse gave me epinephrine IV instead of IM all bells and whistles went off my troponin levels were .81cf6 dammage was done but how much ???? who should i see next
Probably just related to the epic, is your echo normal?
How bad is a troponin level of 5.2? I have cardiomyopathy and unstable angina , cardiac cath was normal.
Am Rahana…..recently my mom felt uneasyness in heart… V went for a check up and this was the result… Can u please explain me what does it means…
Ecg diagnosis info.
800 sinus rhythm
132 low voltage(chest leads)
Trop T <40 ng/2…
Sir !My age is 35 year , sex : male , my test Troponin T HS value 1355.0 pg/ml shows ? And eco test shows normal biventricular systolic function . Shows ? Nestemi ?
I’m a 40 year old male in good health. Last year I was very sick for three days (Friday, Saturday, Sunday) and started to have chest pain early Monday morning. Went to the ER. EKG showed elongated ST wave. Blood showed elevated Troponin.
I was told that I had a heart attack and that they were going to do a Cardio-Angiogram and maybe place a stint or two. Angiogram came back clean and no stints were placed. Still had elevated Troponin.
Echo Cardiogram was ordered and they thought they saw a potential splitting of my Aorta. I was prepped for open heart surgery.
Before surgery, they decided to do a CT scan. Scan was clean and no surgery was performed.
They placed me in a bed and continued monitoring me for 36 hours. I was released without a diagnosis and still don’t know what happened. They gave me some blood pressure meds and Aspirin with a follow up appointment in 1 month. At my follow up appointment with a PA, not the Cardiologist, I was told they weren’t sure what happened.
I am a member of the Army National Guard and meet their fitness standards every year (sit-ups, push-ups, two mile run). I felt fine after I was released and haven’t had any chest pain since that morning last year. I have not taken any aspirin or BP meds, besides Ibuprofen for occasional head aches since my 1 month post op check up last year. I have lost my trust in the doctors who treated me.
Question: Am I one of these “Type II MI’s” you mentioned in your article?
By the way, your article was very insightful.
Question: Did I really have a MI?
Your coronaries were clean, you didn’t have a heart attack caused my artery occlusion so it wasn’t a heart attack as conventionally thought of, which is good news. Therefore it is a type II MI by definition although it sounds to me you need a follow up with someone that will review your records that will be able to explain to you why you had these symptoms!
Omg i had the same 3 weeks ago as you but i do have mild coronary artery disease but they can’t explain why my levels were high and I had high blood pressure and high cholesterol but no explanation why really frustrating so I understand what you’re going through.
I had the same as you Sharon. Angiography only mild. I had no chest pain. I had strong heart pounding, head pounding, pins and needles, shaking’ dizzy and very sweaty.Both blood tests came+ but every other tests came normal. No one knows what happened for me to have a attack. Week after I am still having same symptoms but very mild. Went to ER blood test came negative. I am so ?
I was hospitalized in October of this year due to anaphylaxis shock from contrast… My tropinin levels increased to 2.39…what does this !mean? Gastrointestinal Dr said I had a heart attack but hospital never told me…should I be concerned?
You need to see a physician and discuss the hospitalization and the cause of the positive troponin, it shouldnt just be left unanswered. Its difficult to say if you have cause for concrn or not without knowing more.
If you are interested in information and therapy for heart disease then feel free to follow my twitter at @MustafaAhmedMD
I suffered a heart attack back in January of 2013. I had a 99% blockage in my right coronary artery. Had a stent placed and have been great since. My Troponin I level was 0.71 (HH) My Dr never explained what this meant. I know the normal range is 0.0-0.05ng/ml so yes mine was high but what does this mean as far as damage to the heart or severity of the heart attack?
I have just been released from hospital after a suspected heartache attack! My Triponin level went from 5 on admission to 1,780 few hours later. The next day Iwas ordered to complete bed rest because my Triponin levels had skyrocketed to 11,800. Why would this level be so high?
you have some damage to your heart, either small heart attack or inflammation of the heart it sounds like
My troponin level was 0.69 what does that mean
My troponin i was <0.03 is that normal
My son 2 years ago had myocarditis.his troponin level still 0,05 to 0.06.he is 18 years old.please I really want to know why the troponin still elevated.
It is likely a chronic elevation of no clinical significance.
I am 40 and exercise very regularly. My TotalCholesterol was 206 and my Troponin l was 27.3 pg. I am a type 2 diabetic. What could cause it to be so high. I did recently start a lot of weight training and starting taking a vast amount of Amino Acids and a small dose of Creatine. Please advise. Your article was very helpful!
Hi . Mine was 0.25 . But anjiagram and other tests shows hear is open and fine . But they never really knew if I’d had an attack or not , kinda left more questions than answers. Can you shed some light on this please
Iam 38
Hello, had chest pain. Went to ER and Troponin was 0. Tested later in the day and it was .1 What does this mean and should I be concerned? Thanks!
Do you know the normal range of lab values as a reference, should be on the results sheet, would need to know that to comment as different places use different assays, regardless sounds a very low level.
Hi I was told my Troponin level of 1008 was significant high but what does this mean and what is the normal range. Confused and concerned.
Did your result sheet have your normal reference range listed on it?
I’ve just had a stent fitted, my count was 21,000
Hi I wondered if you ever found and answer to your question I just had two stents fitted and my troponin count was 2,500. Everywhere I have read says the higher the level the more damage there is. Our numbers seem off the charts. My cardiologist assures me my damage was mild. I’m confused!
I was discharged from hospital yesterday. My Troponin level was <.01. What does that mean ?
Looks like it was normal. Was the reference range listed?
Hi Dr wad in the 1st was acmiyyrf with tropinon of 7 had ct scan of heart and lungs echo and a cath 4 days later my ptimstu tryrstrc my ytoppmom it it Moe 0.1 my Dr cannot explain it I was also constipated for 7 days they had to fig it out in the hospital. Whsy I’d your take
Hi am 43 lady had chest pains went into hospital first blood test ok second was 430 so the told me I had heart attack then done third blood test it was ok so then said didn’t have heart attack there was an error with blood test sent me home on atrorvastatin 80mg for high cholesterol still feeling unwell very tired no energy have been like this now 8 weeks could the blood test be wrong
Hi Dr. Mustafa
I am 34 male. Had chest pain and chest heaviness yesterday. Went to ER and they discharged me after doing ECG and blood Test as both were normal. My Troponin I level was less than 6 ng/l. Reference range listed was 40ng/l. Could you please provide your feedback as i couldnt able to find anything on net regarding the refernece raange. Thanks.
Unfortunately it is different in every setting, you would need to find the reference range of the local lab.
My mother had chest pain during several days ….. Her troponin i level is 0.250ng/ml and there lab range is < 0.300 what does it means ? …..plz tell me ….
It looks like the value is within the normal range that would suggest no heart damage.
I AM A FEMALE, MY TROPNIN TEST I RESULT IS
0.001 ng/ml.
LET ME KNOW THAT IS THIS RESULT SHOWING ANY COMPLICATION OR NOT.
Dr. Sb
I remained quite uncomfortable tonight in between 4.30am and 6.00 am – a bit chest pain, vomit feeling, and some chest stoppage.
Afterward, I got my troponin I test from Excel Lab Islamabad; the result of which is 0.3 whereas its normal or reference range is less than 0.3.
Kindly advise.
Typically repeat levels would be drawn to see a trend, if elevated and concerning for heart further tests will be required to evaluate.
Hello Doctor,
My Mom is 60 Years old. yesterday suddenly her BP raised and ECG was also not well when checked immediately.
After 2 hours, ECG came normal. but TROP T resulted in high to 19.82 as compare to 14.
ECHO test too came high. Please let me know if it is critical.
What was the full read of the echo.
I’m a 58 yr old female. After chest pressure episode at work and transported to ED, all vitals nml (BP range 104-110 / 60-70) P60’s, Afebrile, EKG x 3 over 38 hrs nml.
Troponin fast test in ED was 0, then more sensation test in OBS unit was .09 then 3 hrs later .08 then 0 about 12 hours later.[Lab ref range = < .01]
Cardiac cath showed small plaque area with 30% blockage on Left descending artery. No repairs or stenting done.
CHOL 204, HDL 79, LDL 114, Triglycerides 56.
Sent home on atenolol 25mg, statin 80mg, plavix 75mg, and aspirin 81mg.
I'm worried the b blocker will make my BP too low?
Is dual anticoagulant TX ok ?
I want to go back to swimming laps, is that ok?
As always, the disclaimer here is that i will not advise you directly having never seen you and not being familiar with your entire clinical details. The degree of coronary disease you have suggests no significant flow obstructing blockage and no stenting was therefore needed. https://myheart.net/articles/heart-blockage-explained-with-pictures/. That article outlines some different degrees of blockage. The next question is why did you have a troponin rise? Troponin elevations have a number of possible causes.https://myheart.net/articles/troponin-levels-the-heart-attack-blood-test/ Did you have an echocardiogram, what did it show? There are a number of possible causes of troponin elevations. In your case it appears that with the chest pain, and your clinical presentation (i don’t know the full details of course) there was concern that the event was still related to a possible small heart attack. Therefore the medications you were started on have been started on in that context and are guideline based. I tell my patients to keep a blood pressure and symptom diary, if the pressure drops low then the medications can be adjusted accordingly. In general with those patients who aren’t at a high bleeding risk, dual anti platelet therapy is tolerated well and each case should be assesses by the prescribing team whereby the benefits outweigh the risks. In terms of swimming, i don’t know the story and so I would recommend you ask your cardiologist.
Hi Doc,
My husband had burning sensation in the middle of the chest, back & arms. We felt initially that it may be acidic problem, however, to rule out any severe problem (and knowing the family history) gave him sorbitrate immediately and then took him to the hospital. They gave him antacid and fluid after which he started feeling better. His ECG was taken after frequent intervals and that too didn’t show any specific signs. Knowing the family history, few cardiac tests were also done out of which the Troponin I tests showed 0.04 ng/ML, CPK was 60 U/L and CK-MB was 1.5 ng/ML. The ECHO showed 45-50% LVEF, apex hipokinetic, (N) CCD, E&A Equal, Trace MR/TR, No clot/Veg, No PE seen. He is diabetic for past 6 years and the recent HbA1C was 6.5. According to you, are these symptoms related with a heart trouble? Pls. advice.
Its difficult to comment on the troponin levels unless the normal local range is provided, this should be on the results sheet. The CK-MB is normal. Often in these situations its the trend of results, not a single result that counts. More concerning is the echocardiogram, this suggests he has significant artery disease and likely a prior heart attack. He is also a diabetic, his symptoms may be atypical, Further investigation is required to ensure no underlying critical heart disease.
Hello Dr Mustafa I’m recovering from a heart attack where I had two stents fitted my troponin levels were 2,500 . My cardiologist assures me my heart attack was mild but my numbers seem off the charts. Everything I read says the higher the number the worse the damage is. I’m at home recovering now with no pain and feeling fine. I’m confused.
Its important you get hold go the normal reference range for the test to understand the level of elevation. Did you have an echocardiogram to determine function after the attack, if so that will give you a good idea regarding the extent and significance of the damage.
Tks for your reply Dr apparently my attack was an nstemi. My ecg was apparently normal before the attack and after. It wasent picked up until the troponin test. My the GP assures me that the hospital wouldn’t have sent me home if they were concerned. I’m not overweight I don’t smoke but I suffer from PTSD which has led to previous chest pain with panic attacks and ER visits. The high levels of troponin scare the life out of me though.
51 year old female/ not overweight/no health issues
Recent dental visit initiated a painful TMJ that radiates to my jaw (Advil normally works) and left an put a crown over an infected tooth. Along with a burn on my chest (that I suspected heartburn from 2 months of Advil consumption) Pain got so severe that I went to the ER. ER doc after EKG and BP gave me an antibiotic and said he believes its related to dental. Until Troponin came in at .26 and I was admitted.
another EKG – Normal
HDL – 81
Echo – Normal
XRay – Normal
CT scan with contrast – Normal
BP – Normal
However more troponin test taken that resembled a wave .23 .33 .26 .44
ER doc had no recommendations and sent me home with an aspirin a day and follow up with dentist first and cardiologist 2nd
after nearly another month of tooth pain, went to another dentist and it was pulled and revealed an infection. TMJ is still painful and I could barely open my mouth till this day
Follow up visit with cardiologist
BP normal
Stress test with pictures – normal
No understanding as to what happened I am considered otherwise to be at low risk. Is there something missing here? I am reading too many similar situations as mine. If that enzyme is specific to the heart and there is no indication of heart disease and other major problems, could extreme pain in jaw/tooth/workout muscle injury be stressing the heart. I will continue to search because there has to be an explanation or something missed here.
Sir, my younger brother admited yesterday date 05.03.17..in GG Hospital Jamnagar..with chest pain..in centre..first it confused due to gestric. All ecg normal, bp normal. Some blood test yesterday report says no blokage in heart. Now today dr. suggest Tropinin-1. Normal range Trop-1 in serum 0.3 ng/ml. Result- 3.82…written in report indicates injury to myocardium. Now they start treatment with some injection..and ecg reports. They say minor attact. They may further suggest ecco test. He is habitual of smoking..(bidi). We family members are confused. He is well..walking , talking, eating.age is 48. Sir pl guide..pl…suggest..what does mean????
He has had a heart attack as suggested by the chest pain and the test results, next other tests will be needed (echo, angiogram etc..) to determine treatment plan.
6 year old son was recently diagnosed with SVT and went to e.r. yesterday with chest pain. Tropinin 1 was <0.03ng/mL and Tropinin 1 (poct) was 0.01ng/mL is this of any concern
Troponin 1 (normal range 0.00 and 0.04) thank u in advance
a troponin level of <0.015
Is that elevated?
3 different test came back with same result.
It doesn’t sound significantly elevated, do you know the local laboratory reference range.
Hey did u get and answer mind was. 0.03 cardic troponin 1 what does that mean can someone help me
40 yr old female. Felt horrible. Went to bed early. Woke with crushing chest pain and difficult breathing. Called 911. Ekg in Ambulance normal. Hospital drew blood. Ordered posterior ekg. (On back). Showed st elevation. Troponin. .40 . Straight to cath lab. 2 stents
40 yr old female. Felt horrible. Went to bed early. Woke with crushing chest pain and difficult breathing. Called 911. Ekg in Ambulance normal. Hospital drew blood. Ordered posterior ekg. (On back). Showed st elevation. Troponin. .40 . Straight to cath lab. 2 stents
Hi Doc,
I’m a 39 year old male after recent heart attack. I had 2 stents placed and currently still recovering from it. Overall feeling better, now waiting for a stress test 3 months after heart attack. My question is in regards to troponin levels and how do my results correspond to the damage of my heart. The lab results indicated highest level of troponin at 40.7 where normal range is considered at 0.7. Is this indication of significant damage to my heart muscle? I’m honestly worried
A level as high as 40 is very significant, an echocardiogram will tell you the degree of damage.
I am a 58 year old male, and had a weird pain deep in my chest. I sat down and it went away. I climbed some steps,, and nothing. I still felt weird, so I went to the ER and my ekg was normal, they were about to let me go when my troponins came back slightly elevated. The told me I had an MI. I was admitted and given all kinds of clot busters ect. A few hours later my my troponins went back down. My doctor seemed baffled. My echocariogram was normal, and cath showed CAD with less than 50% stenosis, and no obstructions. I understand this is really bad, and that what ever it was didn’t dissolve, and my prognosis is bad. My doctor didn’t tell me this though.
Dr. I was having chest pains and slight pain in left shoulder blade, I went to the er as there is a family history of MI’s. I was admitted to the hospital for observation overnight. My troponin levels were .010 at er, .022 at 5 hrs, but then back down to .011 at 12 hrs. The reference range says <.028 for normal. In addition I had several ekg's (10 lead I think) all of which appeared unremarkable (I think that was the verbiage used). I was also on telemetry for the entire stay. At around 7:30 am the Dr said I had a brief period of tachycardia. I'm scheduled for a nuclear stress test may 5th and will then have a 30 day event monitor. So it doesn't appear that I had a heart attack but the tachycardia does concern me as I've had a event monitor in the past and all it showed was pvc's and was told it was ok(roughly 5 years ago). Are the test that have been ordered (stress test, and event monitor) likely to be enough to show what's going on or are there additional tests I should be having?
It looks like your troponin was within normal levels. In this setting i generally would order an echocardiogram and if normal then its reassuring. This could potentially be ordered as an outpatient if felt appropriate. The nuclear stress test and the holter monitor seem a good idea.
Given the large amount of people we have been able to help here, we are starting a twitter to help keep heart patients up to date with advances and relevant information. Mine can be followed at @MustafaAhmedMD
Hello Doctor- thank you for your interesting article.
I suffered a non stemi heart attack some years ago – presenting with acute chest pains and was treated with two emergency stents being inserted.
My triponine reading was 0.33. My insurance company has declined cover under the policy and say that a reading of more than 0.6 is required for them to consider it a serious heart attack.
It certainly felt serious to me! So I was interested in your views please. Would you consider that I had a serious heart attack?
Thank you
Andrew
Sounds odd to me that it is being questioned. The designation of massive would depend on damage done. The fact that you had unstable symptoms and required an emergency procedure would typically mean you had at least unstable angina and the elevation of troponin above the normal range would mean that the diagnosis is NSTEMI. Sounds a serious situation to me. I would request the normal reference ranges from the lab where it was done to confirm an elevation above the normal range.
Given the large amount of people we have been able to help here, we are starting a twitter to help keep heart patients up to date with advances and relevant information. Mine can be followed at @MustafaAhmedMD
Thank you Doctor for your quick response.
Is there any publication that you can refer me to which discusses the seriousness of various levels of Trippone? I’m interested to know why the insurance companies selected 0.6.
Thanks again
Andrew
The value you need is from the testing place where you had it done, i suggest that you call the lab there and ask for the labs normal reference range.
Thanks again Doctor- I will check that out.
But are you aware of any literature that supports the insurance companies adopting the 0.6 threshold?
Kind regards
Andrew
I have not heard of any literature that supports the 0.6 threshold, i would recommend getting your treating physician to write a letter on your behalf clearly stating you had an acute coronary syndrome.
Thanks again Doctor. Much appreciated.
male 35 years old history of anxiety disorders and panic attacks. In the last week or so i have had multiple ekgs and troponin test because i had an episode where my resting heart rate shot up to 160 and my BP 188/99 every doctor that did the ekgs said everything looked fine the poc troponin tests was always 0.00 and the last troponin test was not a poc test it was a lab test and the result was <0.017 with a reference range of 0.00-0.059 so i was wondering if this meant my troponin level was indeed elevated even if just slightly and if so what could be the cause and should i be concerned? also want to mention 4 to 5 months ago i had a echo and a stress test and a stress echo and cardiologist said all test was great and during the last troponin test my egfr was 53 non african american and creatinine was 1.51 reference range 0.60-1.30 and potassium 3.1 reference range 3.5-5.1
Your troponin was < 0.017, that is a normal result and considered negative if the reference range was 0.00-0.059. Given the large amount of people we have been able to help here, we are starting a twitter to help keep heart patients up to date with advances and relevant information. Mine can be followed at @MustafaAhmedMD
Sir my patient troponin t test value is 11 what should I do plz reply me
Seek immediate medical attention.
47 y black female. History of v Rach presents with center chest pain twice in ER. Both visits EKG is normal but troponin test results show x-no results after several runs on both visits. Visits were 7 months apart. Any thoughts on what could cause this
Should be v tach
What did the rest of the cardiac work up show?
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Ive recently been diagnosed with unstable angina and microvascular disease (april 2017) have had ecgs which always come back abnormal with changes in them, have also had an angiogram, a myocardial perfusion scan (which showed lack of blood flow to the heart) also had an echo,mri scan and ct scan which have come back clear. Have been admitted in to hospital quite a few times since April due to the chest pain, troponin levels always come back over 3 whatever this means but im still currently having alot of chest pain that radiates in to back, left arm the pain is excruciating sometimes find myself in tears with it! Any help would be appreciated Thanks
Have you tried nitrates and calcium channel blockers?
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Hi.
My Troponien I (Stratus) level is < 30, with the reference being 0-70 ng/l.
Is this in range?
Hi I took potassium and calcium while badly dehydrated n my is still very tight one week later. I put out bins earlier which was very heavy n now feel like nauseous weak heart feels sick!! Seems like too many electrytes with no water has damaged my heart !! What should I do?
I suggest you see a medical professional to get checked out.
Hi, my troponin level was 1.720, normal range is (0.000 and 0.045) I know it was elevated because a heart cath was done. No stents was placed. Dr. Stated that I have very strong heart muscles. My questions is, although my tests came back normal. EKG, Cardiac Cath and another test that looks like a sonogram. Did I actually have a heart attack? And what other reasons that may contribute to elevated troponin levels?
it sounds like you didn’t ave a heart attack in the traditional form. The normal sonogram would be very reassuring. The stress of whatever caused the initial event may have led to transient heart stress, but that doesn’t necessarily mean any lasting damage.
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Serum trop I Level : 18.059 ng/ml
What is this result
What is the normal reference range at that lab?
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Hi, my father went in to the hospital because he was having trouble breathing. They said he had pneumonia in one lung and his trip level was .09 with the normal level being at .04. What does this meanmmm
Depends on many factors. In some cases the pneumonia can cause it, in some cases there may be some heart strain. It needs to be watched and trended but most importantly put in context with the overall situation.
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My name is rajkumar my mother is serious case blood sugar and heart problem please suggest
My son head chest pain bad hes 20 years old no alcohol drug or tobacco use hes a health freek his level was 5.8 two 6 weeks later intensive care a million tests and cnt find what caused nstemi
i went to one hospital and my troponin level was <.01 and a week later I went to another hospital for a digestive issue and my troponin level was .017. I read a few articles that a slight raise in troponin levels could be a warning. Is this true? Should I contact a cardiologist?
If it was elevated above the normal range then you should certainly inquire as to why.
The reference range was .000 to .05 so would .017 provide a negative troponin result or does that mean I have a normal level of troponin ? The articles I find online show any release of troponin should be a concern . Maybe I was wrong to assume but I thought it would be 0.000
sir my father 71yrs had high sensitive troponin-t test done in which the observed value si 443.8 unit pg/ml while the biological reference interval is negative :<14.it says correlate clinically.
conversion factors are pg/ml x 0.001=pg/L, concentration in pg/ml x 1.0=ng/L.
Doc, could you please demystify what is his value against benchmark in simple converted numbers?
sir my father 71yrs had high sensitive troponin-t test done in which the observed value si 443.8 unit pg/ml while the biological reference interval is negative :<14.it says correlate clinically.
conversion factors are pg/ml x 0.001=pg/L, concentration in pg/ml x 1.0=ng/L.
Doc, could you please demystify what is his value against benchmark in simple converted numbers?
hello Sir,
My fathers trop T level was 0.08 after 2 hours of starting of Chest Discomfort.
However, testing Trop T level after 13 hours was 0.02.
The lab reference range says 0.1 = positive (for AMI)
Was this due to a Heart Attack ?
The values you have stated are below the reference range for a heart attack according to your reference range? That would imply the test was negative.
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hello Sir,
My fathers trop T level was 0.08 after 2 hours of starting of Chest Discomfort.
However, testing Trop T level after 13 hours was 0.02.
The lab reference range says 0.1 = positive (for AMI)
Was this due to a Heart Attack ?
hello Sir,
My fathers trop T level was 0.08 after 2 hours of starting of Chest Discomfort.
However, testing Trop T level after 13 hours was 0.02.
The lab reference range says Less than 0.014 is negative and greater than 0.1 is positive (for AMI)
Was this due to a Heart Attack ?
Hello. I was in Switzerland and I got on an exercise bike and my heart rate was already at 140bpm before even working out. Normally it’s around 100bpm or less by the time I walk to the gym. So I tried different bikes and they all read the same so I went to the ER at the local hospital. They did an ECG, which was normal, and I got the following numbers from a blood test : Troponin T hs, measured in pg/L was at 14 (reference was 0-14) and Creatinkinase was at 185 (reference 24-190). So both were on the highest bounds of “normal”. The directing doctor was also their chief cardiologist, and after monitoring me for a couple hours the let me go, assuming it was a Sinus Tachyardia event. What do you think? Especially with the Troponin and Creatinkinase being so elevated? Thanks very much.
The values were in the normal range so regardless they were negative. You were seen by a cardiologist and they were reassured and discharged you. It seems like there was no concern for significant effect. The CK of 185 is not regarded as elevated. All of that is good. They would have taken your clinical picture and heart tracing in to account also. I would certainly recommend close outpatient follow up with a cardiologist so the work up can be completed.
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Hi i had a blood test done that came back
with Trop I lvl 0.03 with a reference of 0.00~0.04 is this cause for concern?
The level you reported seems to be in the normal reference range.
Hi I recently went to the er for chest pains so of course they gave me a blood test which came back with a troponin I level 0.03
With a reference of 0.00~0.04 is this cause for concern?
I went to the hospital due to my hereditary angioneurotic edema in my eyes/lips/tongue & throat, come to find out I had triple lobe pneumonia as well. My blood pressure was 161/92 and dropped to 77/51 within seconds and I went limp unresponsive but I could hear & see what was going on around me, my Troponin T was 0.13 ng/ml critical.
I don’t know nor understand what that means or what happen.
Could you please help me make sense to what happen to me?
Thank You Much … Kathy in Bradenton, Florida
You had a reaction and your body appears to have gone in to shock, its difficult to tell you more without knowing the story. When the body is under major stress of course the heart has to work harder and as a result the troponin test may be elevated. This does not necessarily imply heart damage. The treating Dr should also determine the need for further testing in this setting. Make sure you follow closely with the dr.
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I went to the ER with chest pain. troponin level was less than .03, 3 hrs later .87 and 3 more hours 2.88. Cardiac Cath showed no blockage, ultra sound showed no issues. MRI of head neck and chest showed no problems. Was discharged with instructions to follow up in a few days with my doctor. I am completely exhausted and have no energy
my serum troponini level is 40 ng/L < waht does this mean please
It depends what is the normal reference range is. You should certainly discuss that with the treating and ordering physician.
troponin-i report >0.06 this is normal
Depends on the local reference range that should be on the report.
I had gastric bypass surgery Jan 29. I am almost 70. Jan 31 ran a temp of 103.7. X-ray showed slight particulate matter. WBC was 10. Pain was intense. Treponin level 31. Vancomycin, metronidazole and another antiobiotics were given in succession . Feb 3 treponin was down to 12 and on the 4th it was 9 and I was released on po meds. So I am assuming the event was connected to the surgery and pneumonia. Does this put me at higher risk in the future? They also did an echo but haven’t heard the results on that. I am continuing with mild chest pain. How to differientiate pain from the gas of surgery vs pneumonia vs heart
Many things can cause troponin elevation, and the trick is to rule out a direct cardiac cause. The troponin needs to be interpreted in context to the overall situation. Its complex and requires a thoughtful evaluation. If the echo is normal that is reassuring. If the troponin is significantly high then in general further risk stratification testing will be performed either during the hospitalization or at a later time. The results of that testing will help determine risk.
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Hello Dr. Mustafa Ahmed. I am at the best age of 60. I had a left atrial Myxoma excised some 5 years back it was quite big just over the size of a golf ball I was told. Some few weeks after I took what they said is an attack of fast AF. I have been taking them randomly ever since and most of the time I just take meds and relax until it passes. In the past six months or more it has been more severe lasting some hours at 180 to 200bpm with BP of around 89 over 99. Lot of pain involved so I have attended emergency dept. I was told few months back that my troponin has went up from average of 3 to 6 and last night it had tested at 8. Doctor in A&E said its OK until it goes over 11 but I am getting a bit concerned over the ferocity of the attacks and the longer time I need to get over them. My AF comes on like a express train straight away it jumps from normal to 180 or more and pulls me straight to the floor. If I try to stand I would fall. Could this possibly be SVT instead of fast AF or what is the difference?
The first step is to characterize the episodes with a monitor, then the next treatment step can be decided. Given the symptoms i would recommend seeing an electrophysiologist to discuss the next best step and treatment options. Whatever it is, it can likely be treated effectively.
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Hello, I have Bain in my chest 3 days, I made troponin T HS and result is 7.8 and reference range between 12.7 and 24.9, is it dangours , I must make eco ? I am sport man and my age 47 Thanks doctor
Firstly, your care needs to be directed by a specialist you are seeing. An echocardiogram if recommended is a way to look at heart structure and function.
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Hello Dr
What do you please if my troponin level 15->13
Is that too high enough to get heart heart? Just turned 64
and have family history of hear diseases.
Thank you.
Sorry, need advice, my level was of Troponin <0.30 ng/mL…Does it loo ok? Left ER , was there becasue had facial numbing but no droop, ran ekg, blood test and ct scan for clots and they said I'm ok. I'm 38 and do workout a lot at the gym, BP usually 139/82.
Depends on the normal reference range for the lab, will be on the paperwork.
My trop 1 range is. 0.22 is normal
my troponin comes 0.006 is it normal
what is refrance range of troponin i ..????????……..SIR PLS REPLY ME……
MY FATHER HAS IT 0.02 . I GUSS THE RANGE ON REPORT IS INCORRECT OR MISPRINT ……
PLS REPLY WITH RANGE.
Recently my troponin level was a 2.4. What does this mean? Heart Cath was done to determine if I had heart muscle damage. No damage detected. What might have cause this high level and was it a heart attack?
As listed in the article a number of things can cause troponin elevation. Hart cath shows blockage to arteries, not heart damage, the echo will do that. Its possible that there was a transient blockage also. Important to look at all possible causes and then determine mechanism, difficult to do without being the treating physician.
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My husband has been admitted to hospital 2 days agowith a heart attack. Triponin levels 355. Local ref >14.
He has today just had an angiogram which shows everything is clear.There are no blockages and no underlying plaque
4years ago he had a major heart attack caused by 2 blood cloTs on the left circumspect coronary artery. On investigation angiogram they were unable to find the cause of the cloTs. There was no underlying plaque. He has flown the day before Heart was left with 35%. So they never found the cause. Once again it appears they are none the wiser. Do you have any idea what might be happening or what else we could suggest they check. They are talking about sending him home as the angiogram is clear. Many thanks
The left ventricle needs careful evaluation to ensure no clots within it. The presence of a PFO also needs to be ruled out with echo and bubble study.
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Did I have a mild heart attack without being told until follow up from ER visit. High sensitivity troponin t level is <6 ng/L. Ref range is 0 ng/L – 14 ng/L.
Sorry meant to say in previous comment that the heart since the first heart attack is only operating at 35%
No underlying lesions were found.
Heart has not improved over the past 4 years. Any insight would be gratefully received. Many thanks.
What if the troponin level is <0.000 (below 0) Is it dangerous for heart or not..please let me know it's serious
It means its normal.
i have a continue pain in left side near the heart since last 1 year i have normal echo ,ecg,and tmt but have little increment of trop t level than normal level , i visit no. of doctors but cannot get comfort of this pain now i feel heaviness in left arm also please till me what i do …now it is very hard to bear this pain so please suggest me what i do.
It may be worth having a trial of medications for angina, such as a beta blocker and a nitrate, something worth discussing with your cardiologist.
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Is a troponin t of 1379 bad? I just had a heart attack 3 days ago.
Depends on the reference value in the testing lab.
32 y/o F 28 weeks pregnant- was having a normal morning playing farm with my son- started the nap routine of getting him settled with a snack and his morning TV allotment- when I experienced a sudden onset attack- I had pain in my upper left chest- got dizzy- nauseous- quickly texted my husband to come home- and my vision started getting blurry- I started to move toward the couch and everything went black. Woke up about 4 mins later with a pounding headache- dripping sweat- feeling exhausted. My husband tells me I was white as a ghost and clammy when he got home. Fast forward 6 hours to the ER- EKG clear- Troponin at 11 when >11- leg ultrasound- chest xray- head and chest CT scan all came back clean- BP was slightly elevated for me (av 115/70 ER 130/85- says went up to 158 after CT with contrast) fetal monitor was good- was discharged without any paperwork- told to follow up with my OB. OB just said sometimes these things happen during pregnancy and we don’t know why… not helpful. Headache, dizziness and malaise took 3 days to subside. Had pins and needles sensation in my scalp and pain in my left thigh (started after walking a few minutes through the hospital to our car). Should I make an appointment to follow up with a cardiologist?
Would be good if anything for reassurance.
my collegue HS C tROPONIN TEST IS 1.1213 NG/ML. IS THIS SERIOUS…??/
I’m 45 years old last year at 44 I had a heart attack and one of my arteries tore. In December I had another artery tear. And I just got out of the hospital yesterday I was there since last Saturday I went in with chest pain and my troponin levels were at 0.11 what does this mean was this a heart attack because the pain was unbearable.
I went to the ER last week feeling in and this is my result is this normal?
Component Your Value Standard Range
Troponin I <20 ng/L <=30 ng/L
The reference range for Troponin is 0-30 ng/L, which is consistent
with the 2012 Third Universal Definition of Myocardial Infarction
cutoff value for the diagnosis of MI. In the appropriate clinical
context, the level of a single troponin is not diagnostic of MI.
Serial assays are recommended, and must be correlated with clinical
and EKG findings.
I work in a hospital and draw peoples cardiac panels, I had to go to the ER 4x’s myself with horrid chest pain, all my cardiac profiles were normal that’s a 9 hour stay in the ER!! I actually had the widow maker and almost died. I was only 50. They need to make a better cardiac panel test for detecting the widow maker
Sheri, is it? My name is Mike. I also worked in th Hospital as an ER, Clinical Social Worker. I suffered several “ incidents “ until having troponin levels of 47 or .47? This was my third event. Moreover, I had numerous blood clots in my legs, resulting in a P. E. Only two months post the MI.
Please let me know how you are and what your doing and or getting so as to improve or maintain your health. Best wishes, Michael
Dr., My mother had readings of troponin 3.(something), then since two days later a reading of 1.(something). This can’t be a heart attack or damage with levels dropping so low afterward her symptoms of back of neck hurting and upper arms. She is diabetic, 88 yrs old, heart disease, and kidney disease. Kidney doc had told her she had 3000mg of protein in her blood that kidneys couldn’t get rid of.
She is in hospital and cardio doc said: She had heart attack, stent might not do good, wants her to walk and see in hospital if she gets short of breath, also she has heart valve leakage.
I really don’t think she had heart attack, but kidney disease causing high troponin levels. Her ER incident was also cause by extremely high glucose numbers! Of which the cardio doc said it probably was not true readings.
Can you explain?
Troponin levels typically peak the day after a heart attack the begin to fall. Its important to take everything in the clinical context in to account when interpreting the findings. In an 88 year old, often conservative treatment may be preserved if there is uncertainty. Other tests such as the echocardiogram, the presence of symptoms and and clinical stability are also important.
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Hi my father had chest pain last night his body was cold and numb later he had some fits when we reached hospital. Gis troponin I values is 9.28ng/ml n reference values on report says >.30ng/ml acute mayocardial necrosis
Plz explain
The troponin levels are high, there may have been heart damage. Discuss with the evaluating team.
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Hello Dr. Ahmed.
My 70 yr father was recently hospitalized because of blood pressure being 86/50. We has weak and possibly fainted for a brief moment. At the hospital, his 1st blood work had a low troponin I level, then by the 3rd blood work, it had risen to 2.8. His EKG was normal. He then signed himself out after drs wanted to perform an angiogram on him. (terrible, I agree) Besides an echocardiogram, are there other tests that would prove a heart attack happened?
Also, at a 2.8 troponin I level, is he at risk for more damage to occur at any moment?
Looking forward to your view.
Thanks so much.
Stress testing and echo may show areas that can represent scar or tissue with compromised blood supply. The key in the interim is good medical therapy and recognition of unstable symptoms.
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My son in law died 7-24-17. EMS tried to resuscitate him but couldn’t. The autopsy was done but no troponin, no heart damage visible with “spontaneous arrhythmia with mod. intrusive coronary atherosclerosis” as the cause of death. The LAD artery had 65% blockage and a branch off had 50% blockage also. Why would no evidence of troponin or damage not be evident. He was a healthy 47 year old, no medical history and no meds taken, no other physical problems presented either. Our family is really suffering from his loss with no answers. Any thoughts would be appreciated.
I am a 27 year old female, 5’10 about 140 pounds. I am not totally out of shape but I am also not in the best of shape. About a month ago I was jumping rope and on the third jump I felt something weird in my upper stomach/chest. My heart started pounding very hard and fast. I felt like I was going to pass out so a neighbor drove me to the hospital but on the way there my heart went totally back to normal just as fast as it started. They did an EKG and it came back normal, but my troponin levels in my blood were .10. They made me stay and took more blood about 4 hours later and it had gone down to .09. They told me that normal was .08 (even though I see most people say .04 or less is normal) and that since mine was going down I could go home. I had an appointment with a cardiologist and had a stress test that he said looked good. He told me not to worry and that he thinks it might be SVT and that I might have an extra electrical something on my upper heart or an extra nerve. Could my tropinin level have been raised because of SVT?
Yes, very fast heart rates from svt can potentially cause small elevations in troponin that are not necessarily of concern particularly in the setting of normal cardiac testing otherwise.
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Iam 34 years old ,my blood test result showing the troponin is 1.96 pg/ml.this showing has any problem
Hi I was having some tests done the other day (originally they thought I had a PE due to past history – but I didn’t)
They found my troponin levels to be >150 so put me in a ambo to hospital.
Apparently they triple tested it and came back the same.
In hospital they still thought I had a or but turned out I didn’t and 8 or so hours later they did another troponin test that came back as just over 30.
Because it wasn’t a PE and I am already on large dose of blood thinners they sent me home, I still don’t know what happened.
Three or so days prior I had squeezing of my heart and I fainted and was physically sick but went back to slee shortly after and thought I was ok. I am a 30yo female.
Is 150> very high?
Apparently my ecg came back with minimum scarring and only mildly damaged valve.
Question, on Monday, I ha an episode of elevated heart rate (over 165) for approx. 4 hrs. by the time I went to ER. I was diagnosed with PSVT. My troponin level topped at over 700 (normal for our hospital is less than 26), then by next morning, was 417. I did have a normal echo, and supposed to have a stress test, and then to see an electrophysiology cardiologist.
My question is, will the damage that was done during those hours of tachycardia be permanent?
I was not given any sort of restrictions on activity, but I am a bit fearful.
Thank you for your answer.
There may not necessarily be irreversible damage if the episode was felt to be a demand type troponin elevation due to elevated rate. Particularly if the echo was normal.
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My level was .023. I had a blood pressure of 227/108 with a migraine that day. Is this level normal? It was .06 in June.
What was the normal range given on the lab sheet?
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what does a troponin i level of <0.010 mean
That its normal
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Hi my troponin levels are 6 and 7
Is that fine?
It depends on the local reference range.
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Hello,
I want to tell my story and i hope someone will explain for me.
I had a chest pain at night i waited to the morning and went to clinic for check they test my troponin it was very high, they transfer me to the hospital immediately and did what is needed and then they recheck the troponin it was higher so they ho cardiac catheterization to check if there is a block after the surgery they said there was nothing and the heart is clear and not damaged, then they discharge me from the hospital with medicines scheduale and my diagnoses was all fine and clear from any disease. Along with the chest pain i have infection in the lungs and i was stressed a lot, after several days i follow up with my doc he request the troponin test agian and it was normal. Now i’m fine and healthy but still have small symptons the doc said it will disappear soon and i should continue the aspirin for my entire life. Can someone explain what happened to me and why the troponin levels was very high in my blood. Thanks!
Hi i’m hamka . Ive been diagnosed with non stemi last week when i got central chest pain while 10 minutes playing football . After ECG and Eko test both passed no abnormalities but my trop I test shows 12.86 which i refer to the doctor normal result would be below 0.04 . When to do angiogram and passed no blockage were found . But doctor said something a word spezam and told me to rest for a while from playing football . Do u have any kind of similar patient like me so that i can be prepared before i do MRI for heart this upcoming april . Im 24 years old by the way .
@MustafaAhmedMD
Thank you for the article.
Can you please tell me more about this level of Troponin I , as mine today was 25 ng/L
Im a 50y male
I have been having chest pain for several days. I went to urgent care and they sent me to the ER. They did several EKGs and said there was a slight change from the other ones. They kept me overnight for a stress test. They released me saying it was not my heart. However 2 days later I was right back at the ER with chest pains and swollen lymph node under armpit. The blood work shows Troponin T level 0.011 (normal range 0.000 and 0.0010. I’m still hurting in my chest with no relief. My armpit has had swelling since August 18th. What is going on? Should I be concerned?
Have you been evaluated outside the ER by a general physician or a cardiologist, although the ER discharge is reassuring that would certainly be advised.
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Good Evening Doctor.
Ive been fighting with panic disorder for over 12 years now but yesterday afternoon I was working at my job, writing down stuff for a report, and then i felt like I couldn’t write anymore and my eyes felt heavy and weird. Then Im assuming my panic took over and then my right side of my body started to go numb and had really hard time standing up as well as breathing. I thought I was having a heart attack or a stroke. I took 2mg of Clonzopam (spelling) and it wasn’t kicking in or working so i had an ambulance come pick me up and take me to a hospital. The hospital ran a EKG, blood tests, and a urine test. My urine test only showed positive for benzo, which is obvious. My ekg showed great rhythm but just a bit fast because of the panic. Then my blood work came and and the doctor said everything was fine and I just had a heck of a panic attack. My Troponin T levels was <0.01 ng/ml which i believe is good but what has me a tad worried is my D-Dimer readings of .41 ug/ml FEU. The range they show is 0.04 – 0.50. My number comes pretty close to that highest number there. I was dispatched and said I am fine. Does it sound like, with my results, that I am actually ok?
If within the normal range, even if the higher end, its considered a normal test.
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Thank you for your reply. I will be following on twitter!
Sir,
Recently my Mother in law faced heart attack. her troponin i level found .66 lab ,range normal value up to 0.034 and risk value 0.12. RBS,ECO result is good. B/P120/70
I am waiting for your kind suggestion for further treatment,
Hello! I’m a 37 yeard old active male. 5’8″ 161 lbs. I’ve been told I have an irregular heartbeat pretty much throughout my whole life. When I was 28 I remember being hooked up to a heart monitor for 24 hours to monitor my hear throughout the day. Turns out nothing alarming was ever noted or discovered. About a week ago, I admitted myself to the ER for very minor sharp pains around the left side of my upper chest. Maybe I was just paranoid but knowing my history I worked myself up enough to go to the hospital. Once there, the EKG was normal with the exceptions of small arrhythmia indications. My troponin level came back slightly elevated (0.042) but yet absolutely no chest pain or any other symptoms consistent with possible heart attack. A couple of hours later more blood was drawn and this time my troponin level declined back to what’s considered normal range (0.035). I was discharged and referred to a cardiologist. Unfortunately, the thought of my elevated troponin freaked me out enough to head back to another urgent care for a second evaluation pending my cardiologist appointment. There, my EKG came back normal and troponin levels still at (0.035). 2 troponin testes were taken with a 12 hour period and both times they were normal (0.034) I’m waiting to see my cardiologist next week but would like more professional opinions. Also, is there anything I can personally do to help bring my troponin level down??? Thank you so much!
Its in a normal range already.
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My Tropnin 1 level is 0.5
Kindly tell me about our test and what can I do
Good evening. My 19yr old daughter has SVT and had a defibrillator implanted two years ago. A few days ago she got an episode and the device discharged and started shocking her repeatedly. A troponin test done fir her and the result came back of 1.5 level. What does that mean
It likely means a small elevation of troponin in response to the event.
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Dear doc.
I had a chest pain and visited clinic and they did an ECG for me. Results showed irregularities (437 but the biological reference is <15) then the blood tests showed my troponin levels at 2.374. The biological reference as i know is 0.0 – 0.025. My next appointment with the doctor is next week but I'm anxious to know what are tge chances of me having a heart failure and possible heart attack?
If troponin that high, you need to be evaluated in an emergency room.
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Good evening, my dad,s (74 yo) troponin levels are 44 (lab levels <26) and CK 631 (lab levels 40-200).
He is taking blood pressure medications (had heart attack in may 2009) and now for several days has elevated blood pressure.
Other than that he is ok. Booked to see his cardiologist next week.
Should I take him to the hospital/emergency?
Thank you.
He should probably be evaluated emergently.
You can follow our twitter at @MustafaAhmedMD
Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
My father tropinin I level is 0.009..kindely tell me about tropinin level
I’ve recently started a site, the information you provide on this site has helped me tremendously.
Thanks for all of your time & work.
NATS
HELLO DID MY TROPONIN I TEST RESULT WAS NORMAL <0.200 NG/ML IT IS REALLY AN OK READING OF NORMALCY OR SHOULD I BE WORRIED STILL????
THANKS
NATS
HELLO DID MY TROPONIN I TEST RESULT WAS NORMAL <0.200 NG/ML IT IS REALLY AN OK READING OF NORMALCY OR SHOULD I BE WORRIED STILL????
THANKS
NATS
I wasn’t aware that a elevated troponin is concerning for my research, which has ties with cardiac arrest. As far as I know, I’ve had a patient who was exhibiting pneumonia but was not showing signs of cardiac damage. Since old blood tests are not sensitive enough to detect the levels of troponin in the body, I’ll try to buy some point-of-care tests that we can use so that we can remedy our research accordingly.
Hello, Dr My Report says troponin level is 11 and ck level at 3.8. How much severe is this heart attack?? (1 to 10) will I recover??
I am have a kidney stone and mild inflammation and very painful.
Regards
My Troponin I is 0.001 (ref. range is less than 0.01)
CK (total) is 90 (ref. range is up to 145)
CKMB is 6 (ref. range is up to 25)
is this normal?
Can you please comment on how concerning do you think is chronic tachycardia with underlying autoimmune – mixed connective tissue disease (sle, ra, sjogrens)? Resting HR is always in high 90’s to mid 100’s bpm. I’ve had episodes of chest pain, shortness of breath and HR as high as 145 at rest. Continuous EKG showed ST and SV tach at ED visit for the durarion of 5 hours while many tests were ran. They measured troponin I once during that time and it was within normal ranges. I wish they did troponin T, since it looks like a more specific test. My understanding is the same test should be used in any subsequent troponin measures, so I might be stuck with troponin I version. I was given high doses of IV steroids and my HR started to go down to 80’s. No PE, blood clots, infections, etc. In short, no known cause for that event as I suspected would be the case. I declined to be observed over night and was sent home on 40 mg steroids per day for 4 days. I am on plaquenile, LDN, rx vit d, etc., for AI condition. Had foot surgery 4 wks ago so can’t do stress test at this time. Cardiology called the next day but I scheduled a consult with PA in a week. Maybe echocardiogram can be done instead of stress test to further evaluate? AI conditions pose such a challenge on knowing what is what or how to treat it, thus my lack of concern, or maybe I am just tired or used to it. Do you have patients with systemic AI issues and how concerning is heart involvement? Any other suggestions? 40 yo female. I will follow you on twitter. Thanks!
Did you find out any answers with the testing?
Hi I recently went to the ER with chest pain and shortness of breath. They checked my troponin twice. The first time it was 33, the second time it was 28. The normal range is supposed to be less than 20. May I have suffered a heart attack.
Its important to follow up and have those findings reviewed. Troponins need to be interpreted in accordance to the clinical situation.
You can follow our twitter at @MustafaAhmedMD
Disclaimer: The comment response is opinion and in no way affiliated with my employer. It is a vague response that is not to be used as direct medical advice and in no way should replace the opinion of a medical provider.
Hi Dr. Mustafa,
My Troponin l(quantitative) test result is < 1.5 and the reference range is less than 19.0. The unit is ng/L. Is this normal? Thanks and God bless.
One of my friend test shows 0.424 and they mentioned normal is 0.00 – 0.1, high risk 0.2 …… By reading your article i realized the grievance/danger of the situation and got her immediately admitted.
In one of your reply you mentioned “normal range vary from place to place and the things used”. And i think this should be incorporated in your main article. It took me some time to understand why your range don’t matches with mine.
Hi guys I first had my first case back 2018 my troponin levels were 177ng was called myocatics I been in a hospital few times over last couple of years been around the 38 42 mark always stayed at that level I have ask doctor’s over time to what it could be causing it does anyone no it and can explain a bit better also my heart skips a beat sometimes thanks
Dr.Mustafa,
I am a young athlete and I had an elevated troponin of .353 with the normal range 0-0.045 with chest pain occurring two days later. When I went to the emergency room my Troponin was .010 with the normal range 0-0.040. Would you consider this damage to the myocardial tissue, when I was diagnosed with pericarditis.
Hi Dr., I just want to ask what does my result mean troponin i of .015 ng/ml from lab reference range says 0.00 – 0.10. I am having chest pains on and of and diziness.
* A Troponi Level of 263 without a heart attack ? *
Two years ago I had chest pain during the night. In the morning I got taken to hospital. I had a Troponin level of 263, so the staff seemed certain I had a heart attack.
My personal data is that I was 61, male, average weight, don’t smoke at all and don’t drink much.
I have no histroy of trouble with my heart, have never been in hospital before for any illness, have BP of about 115/70, a rest heart rate of about 45, and I do alot of hill running, walking, so am very fit. I don’t get stressed.
I got all the tests – echocardiogram, angiogram, x-ray, and a few weeks later a cardio MRI.
They found nothing – the MRI and tests showed no damage except I had “myocardial bridging” which apparently is an abnormality which affects about 10 per cent of folks. My arteries were clear. I was discharded after a night and felt fine and returned to walking / running soom after. They gave me some pills to take but I stopped taking them a few weeks later after the MRI results were released.
After the resuls of my MRI scan I discussed more details of my “heart attack” episode with my consultant:
During the “attack” the pain would ease if I sat up, and seemed to be worse when I inhaled. I felt I had a mild temperature.
It was a dull fixed pain that stayed with me on and off for well over 24 hours – in fact in my night in the Hospital I had to sit up in bed to stop the dull pain and get to sleep.
In the end, the consultants were baffled, but on balance they now believe I probably had * pericarditis * – some kind of virus that affected my heart and caused the Troponin level to rise alarmingly. The fact that the pain was relieved by changing my position seemed to suggest this. Still, a bit baffling. At the moment I enjoy good health and before COVID was back to doing hill races.
Dr. Ahmed,
I am 27 years old with a cardiac history of SVT. It was treated with ablation in 2013 successfully, but I still suffer frequent PVCs and take 50mg of Atenolol daily.
I went to the ER (my cardiologist sent me) with chest pain. After a full workup I was released.
However, I noticed my first treponin level was 0 and my second test (hours after the first) was .05.
Any concern there?
Back in November I went to the ER d/t bp of 215/140 and numbness/ tingling In my hands and arms. Did all kinds of tests and decided I was fine because it had dropped back down to normal. I already had been taking 90mg nifedipine, 50mg losartan, and two 6.25mg tabs of carvedilol. Fast forward to feb i got a different job my bp meds were too strong, had to be lowered. I now take 90mg nifedipine and 3.125mg of carvedilol. I was having a lot episodes where my hr was elevated. Increased carvedilol back to 6.25mg one in am and one pm. Woke up in the middle of the night with incredible chest, back and left arm pain/pressure. And SOB. Got to the point I couldn’t hold my phone in my left hand. Got to ER did tests and labs triponin was elevated to 94. Sent to heart center at bigger hospital. After more tests. They decided maybe I didn’t have a heart attack like previous doctor said. They decided maybe it was just pericarditis. Never asked my family history or anything about me or what had been going on recently only what meds I was currently on. They said too many people rely on triponin and it doesn’t mean heart attack if it’s a little elevated. First doctor at first hospital said it shouldn’t be above 10. They gave me colchicine and ibprofen. Heparin shots the whole time I was in hospital and aspirin. Had nitro twice. Sent home after 2 full days in the hospital and sent back to work. Something not seem right?
I was recently in the er and had a level 56 ng/L of troponin. What does that mean? There’s more details to why they specifically checked and did 2 ekgs and echocardiogram.
This article was incredibly helpful. The ER at Baptist South in Jacksonville, FL told me that my cardiac enzyme was elevated but NEVER used the word “troponin”. Given the treatment I got at that facility recently, I am not even sure that the doctor who took over my case on my first visit there even knew the word himself. He just found every reason he could to ignore my elevated reading.