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Slightly Elevated Troponin I Levels = Heart Damage?


Gena
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HI everyone,

I went to the ER about 2 weeks ago after having chest pain for two days that wouldn't go away. It would subside during the day, but get worse at night when I went to bed. This was a little different than other chest pain I've had in the past. It was definitely confined to the left side of my chest, sometimes radiating in left arm and in my back along my shoulder blade. I had no nausea or sweating, but it hurt worse any time I took a deep breath. My heart was squeezing hard and going along at a pretty good beat. I could not sleep.

At the ER, All blood work and my EKG was normal. The ER doc tested my cardiac enzymes, which can indicate a heart attack and heart muscle damage.

My CPK was normal. = 76

My CKMB was normal = .9

My Troponin I was .06 (normal values according to my lab printout indicate anything above .04 is high/abnormal)

I plan to see a cardiologist soon, but wanted to know if anyone has any knowledge of this or if you have ever had elevated cardiac enzymes without myocardial infarction (heart attack).

The ER doc did not seem concerned at all about my Troponin levels and did not even suggest that I follow up with a cardiologist!!!

Thanks for listening,

Gena

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Hi Gena, I can't help you with the levels thing, but I can tell you that I've experienced very similar symptoms. I never went to the ER, but I did call my doctor who said it was almost entirely impossible for me to have a heart attack. (I'm 19.) So I do know that the pain is possible, but I never had my cardiac enzymes tested, so I don't know. Good luck with the cardiologist!

Meg

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I agree with the ER doctor that this minimal elevation in troponin is not indicative of a heart attack, but I think you're right to schedule a visit with the cardiologist to further discuss your chest pain. I have seen these mild abnormalities in troponin, most often in those with kidney disease. Assuming that you don't have it, I would suspect a lab error (yes, these do happen more than we'd like!) as another explanation. Your cardiologist will decide whether you need a repeat of troponin or not. If you continue to experience severe chest pain, I recommend going back to the ER without any reservations, but hopefully, your primary doctors are advising you already on that.

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