Question. I'm a 73-year-old male with heart disease (I had coronary bypass surgery at the age of 45). I pay special attention to my health and exercise on a regular basis. I went to the ER recently because I was experiencing chest discomfort. Despite the fact that my electrocardiogram and, subsequently, a stress echocardiography revealed no issues, my troponin levels were high, ranging from 57 to 63 ng/L on multiple repeated tests. Should I be concerned about the increased troponin? Is it possible to reduce this level?
Answer. Troponins, which are proteins that help muscles contract, are almost exclusively present in heart and skeletal muscle cells. Reduced blood flow during a heart attack destroys sections of the heart muscle, causing troponins to be released into the circulation. That's why emergency department doctors frequently assess blood troponin levels in individuals who are having a heart attack.
The first tests found troponins that are exclusive to cardiac cells, as well as two subtypes of the protein: troponin T and troponin I. Newer versions of the tests identify extremely tiny levels of troponins at 10 to 100 times higher concentrations than the initial test. High-sensitivity troponin testing can diagnose heart attacks sooner and more precisely.
A normal range varies depending on the kind and brand of test. However, the typical range for women is 0 to 10 nanograms per liter (ng/L), whereas for men it is 0 to 14. When a person experiences heart attack symptoms, troponin tests are routinely performed twice within the first few hours and then multiple times more over the next 24 hours, depending on the results.
Clinicians examine troponin levels and ECG results, as well as the person's present symptoms and history of cardiac issues, to identify a heart attack. Troponin levels can surge two to three times the upper limit of normal during a small heart attack but can reach 500 ng/L during a big heart attack. The readings often climb during a 24-hour period before gradually declining throughout the next week.
Myocarditis, also known as inflammation of the heart muscle; cardiomyopathy, often known as heart muscle illness; and chronic renal disease are some of the many additional disorders that can induce increased troponin levels. Prolonged activity can also boost troponin levels, although only in marathon or triathlon competitors. Sometimes people have increased levels for no apparent reason. The troponin level remains rather stable in such a condition, which may be the case for you. Your doctor was probably aware of this but scheduled the stress echocardiography to look for any regions of reduced blood flow in your heart. Your troponin level may just be greater than the usual person's, but there is nothing anybody can do about it. You may now just continue living a healthy lifestyle!
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