Are elevated troponin levels proof positive of a heart attack?
It is my understanding that there are 3 types and not sure what the ER tests for. I went to the ER with right side chest pain. Took the EKG and other procedures for the doctor to come back about an hour later and tell me they were going to admit me for a angio the next day. When I asked about the blood tests they said the enzyme was present. As I was not prepared to stay at the moment and the pain had gone away, i decided to leave and research this more.
From what I have found (who needs medical training right?) it takes about 3+ hours for troponin to appear in the blood following a heart attack. Troponin however is used by muscles in general so would any damaged muscle produce elevated troponin blood levels?
In my case, the pain was on the right side of my chest, not the left. I do have a sore muscle on the left side of my chest which i can feel when I press on it. The nitro they gave me in the ER made the center of my chest hurt for a few minutes.
Generally, I'm just wondering if the ER was playing it safe and following a cookie-cutter standard procedure for someone with chest pain. I was there for about an hour and in pain for most of it but there didn't seem to be any kind of urgency to my care. Most of the time I was alone in the room with a doctor popping in twice for about a min. Mostly was just nurses hooking me up to the monitors and administrators getting my initials/signatures.
I realize these are questions I should have with my doctor but I do not have health insurance so before I pull the chord on a big bill I figured I would do as much research as possible.
Thanks
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I had a feeling like I had to burp and couldn't. An ekg at my doctor's office was irregular so I went to the ER. They took blood said it was normal but I would have to have it taken again in 8hrs. It came back "Heart Attack". Next day I got 4 stents. A major coronary vessel was 90% blocked, 3 others also blocked. So i guess what I"m saying is that for me the Troponin in my blood was an indicator of trouble. I hope this helps and wish you well.
John Doe 556. Approximately 3 years ago I suffered a one-time syncope , passed out and hit the floor. My my PCP how they recommended visit the ER which I did. This was several hours after the episode. I do not recall the level but troponin one did show up and the ER doc came in two or three times questioning me about chest pain and other symptoms, which I never had with or was not aware of. Bottom line as it turns out I let her found after other numbers test that I had a 90% blockage of the LAD and one other lesser blockage in another area. I had stent placement and have seemed to have gotten along pretty well since then. Prior to the episode I was walking 4 miles several times a week without much problem that I could detect but later and the day when climbing stairs would experience a shortness of breath. A nuclear stress test reveal nothing nor did any other tests but nonetheless my doctor ordered and angiogram which reveal the blockages. The bottom line is, your symptoms sometimes are Insidious and you do not realize they are happening over a period of time. Good luck and hope you determine any issues you may have and have them treated. I was lucky given the fact the Widowmaker artery was nearly completely closed.
My story : I was returning an oximeter test at hospital and had been sitting down. When I got up, I noticed a numbness below my knees and feet. Weird. NO UNUSUAL CHEST PAINS. Only shortness of breath for two months. The ER was right there so I went in. Blood work at different intervals showed an elevated troponin (0.04, 0.05 and 0.06). Normal range is 0 .00 - 0.03 ng/mL. ER put me in hospital, and the next morning said the only way to know was with an angiogram. They found a blockage of 70% in the LAD (the widow maker) and several other much lessor blockages in other places. I could not do a stent at that time because I had appointment at Mayo for lung cancer biopsy. With a stent one has to take blood thinning medication for 6-12 months and therefore no surgery! Instead, they put me on medication. To put in a stent there needs to be a minimum 70% blockage.
Four+ months later (after lung cancer surgery) I had consult with Mayo Cardiology to decide if I needed a stent or could just stay on medication. Mayo wanted to know what the blood flow rate (fractional flow reserve -FFR) was to make a recommendation. If it was acceptable, they would just have me exercise like crazy and stay on medication. Apparently, a lot of hospitals (including mine) do not measure FFR when they do angiograms which is unfortunate as it is key information.
Mayo suggested a specific scan that measures FFR but Medicare would not cover it because the previous Angiogram already showed I had a blockage. I had to do another angiogram and Mayo recommended and put in a stent.
Consider a consult with a good Cardiologist.