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In The Hospital With Elevated Troponin?!?!?!


janiedelite
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I have some degree of chest pain on a daily basis, especially when I stand up and my BP goes up (I have a slightly hyperadrenergic response to my blood pooling). Well I was just doing my normal routine this morning, except I didn't feel like eating breakfast. At 10am I had chest pain and pressure that worsened steadily even though I was reclining with my legs up. I checked my BP and it was 180/105 standing pulse 60, and identical values lying down. Hubby was still home and I had him take me to urgent care where my BP was still elevated but ECG was normal. They told me to go to ER, woopee :)

BP still elevated in ER, but once they put me on O2 my BP normalized and chest pain decreased. All tests came back normal, except troponin which is mildly elevated at .13

So now I'm admitted and had an echo, don't know the results yet. They want to do a cardiac cath/angiogram. The ER doc was great, really listened to my underlying problems. He doubts it's a clot, but thinks it's prinzmetal angina or another result of my hyperadrenergic state.

The problem is that whenever they take me off O2 the pain comes back full force.

Of course, I haven't showered since yesterday. Dirty underwear and all...

I have to get better by Black Friday! Don't want to miss the deals. :lol:

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The cardiologist just saw me and he was great. He's not really concerned about the troponin. Said it was too low to be concerned. And now the severe chest pain has pretty much abated. But of course, I've bought myself a night in the hospital now. They'll check the troponin again and he wants me to do a stress test tomorrow, and to start on an alpha-beta blocker. He's familiar with Mayo's studies regarding mestinon. He says he'll have to do some homework on me tonight...ha ha.

Bottom line, I won't need a cath unless the next troponin is higher which he says is unlikely. I can go home tomorrow. I'll get to shop on Black Friday! Yay!

Thanks for the well-wishes!

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I've had a similar experience before with elevated troponin.

They should be repeating it every few hours and as long as it's not climbing by leaps and bounds it shouldn't be anything to worry about. There are other things that can mildly elevate troponin---it could be from your heart racing so much or it could be from another muscle strain.

Hope you get to feeling better soon.

I've done a stress echo before simply by standing up. First time the staff had seen simply standing as a "stressful exercise" but I was well above my target exercise rate.

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I've had a similar experience before with elevated troponin.

They should be repeating it every few hours and as long as it's not climbing by leaps and bounds it shouldn't be anything to worry about. There are other things that can mildly elevate troponin---it could be from your heart racing so much or it could be from another muscle strain.

I've done a stress echo before simply by standing up. First time the staff had seen simply standing as a "stressful exercise" but I was well above my target exercise rate.

Thanks! Yeah, they just drew it again but I can't imagine it will be a cause for concern. Makes sense that just our normal tachycardia could cause it too. I'll be sure to ask the staff at the stress test tomorrow what they deem as my target exercise heart rate. Maybe they'll just let me stand too!

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I have pots/nmh and have had a pretty thorough workup, including cath, following an abnormal chemical stress test. My arteries were clean. I also have a presumptive diagnosis of prinzmetal/vasospasm, though that was a hard diagnosis to get. I'm on florinef and midodrine for pots/nmh, but also a low dose of norvasc (2.5) for vasospasms. I have to say that the combo works for me-- at least for now. My current cadrio/ep said he's seen some of the worst cases of prinzmetal in pots patients. it does take a doctor who is willing to think outside the box, as it may seem that the treatments for pots and prinzmetal are opposed. it took a long time for anyone to address the recurrent chest pain-- and i thought that if i ended up in the er again i was gonna scream. the chest pain is triggered by wild autonomic instability, so both have to be treated.

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Very interesting, Mkoven! thanks for sharing. It was a rough night, several doses of nitroglycerin for the chest pain and some metoprolol. I do think this cardiologist is willing to research my pre=existing issues and think outside of the box. thank God for the ER doc who didn't send me home. I have a bad headache from all the nitro, but minimal chest pain. I didn't realize how much chest pain bothered me until I was finally given something that takes it away. I started with the chest pain 3 years ago, when POTS set in, but it's gotten slowly worse since then.

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Janie,

Please keep us updated on your elevated Troponin levels and if they're going to release you from the hospital today. I hope you can get out and are feeling much better for Thanksgiving and all those bargains out there on Friday. Do some shopping for me....I'm too faint of heart to even approach a mall on Black Friday! Take care of yourself.

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I just did a stress test. My supine heart rate was 60 and standing was 120's. BP was in normal range, and I didn't have any dysrhythmias during the test. My cardiologist is waiting for a call from my Mayo doc to make sure he didn't miss anything. But my chest pain is pretty much gone even without the O2 and nitro. I kept telling them that I'd gotten the H1N1 vaccine Monday afternoon. I still wonder if I had a sympathetic surge of some kind because of the shot, but the cardio doesn't think it's related and will follow up with me and see about keeping me on a beta/alpha blocker of some type.

I should go home sometime today! :)

My poor hubby and I are getting used to having strange symptoms/flares with no explanation. We're just thankful when it's over.

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So happy that's over! Hopefully the new cardio guy will be of help after this is all settled down! Keep in touch! :)

I just did a stress test. My supine heart rate was 60 and standing was 120's. BP was in normal range, and I didn't have any dysrhythmias during the test. My cardiologist is waiting for a call from my Mayo doc to make sure he didn't miss anything. But my chest pain is pretty much gone even without the O2 and nitro. I kept telling them that I'd gotten the H1N1 vaccine Monday afternoon. I still wonder if I had a sympathetic surge of some kind because of the shot, but the cardio doesn't think it's related and will follow up with me and see about keeping me on a beta/alpha blocker of some type.

I should go home sometime today! :)

My poor hubby and I are getting used to having strange symptoms/flares with no explanation. We're just thankful when it's over.

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Hi Janie,

I've been following your post and praying everything turns out OK. I'm so glad it's over for you, and it sounds like your going to be fine other then the usual ANS stuff. Sounds like another unexplained thing with POTS. I don't think the Doc should rule out a sympathetic surge with the H1N1 vaccine. :) with us, anything is possible--- :o:):P Geeze, I took some liguid vitamin D at Costco when they were giving out samples, and about 10 minutes after it felt like my blood turned watery thin, and was pooling everywhere. My heart did flip flops, and I had a huge adrenaline surge. How weird is that...

I hope things continue to improve foe you,------------------meanwhile, your protected from H1N1--- ;)

Maxine :0)

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Thanks Mkoven and Maxine for your advice and support! I'm home, feeling as "normal" as ever... whatever that is! :lol: I was sent home with a script for sublingual nitro. My cardio wasn't able to get in touch with my Mayo doc, and he didn't want to start me on anything that might worsen my symptoms before he had a full understanding of my illness. I'll see him again in 2 weeks.

It's so great to be HOME!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Happy Thanksgiving!

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Nothing like a hospital stay to top off the holiday craziness! :lol: You have a great Turkey Day and be careful shopping on Friday....people are crazy!

KC

PS- Dont worry about answering my message until you are feeling better ok? :-)

Thanks Mkoven and Maxine for your advice and support! I'm home, feeling as "normal" as ever... whatever that is! :lol: I was sent home with a script for sublingual nitro. My cardio wasn't able to get in touch with my Mayo doc, and he didn't want to start me on anything that might worsen my symptoms before he had a full understanding of my illness. I'll see him again in 2 weeks.

It's so great to be HOME!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Happy Thanksgiving!

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