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Elevated Troponin level


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Rene' Koenig Find out more about Rene' Koenig
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  • Elevated Troponin level

    I was feeling horrible while working late two weeks ago. Bad/weird enough to go to the ER.

    They did the usual blood work, EKG and X-ray when I first came in. The results of the first blood work came back fine. As I'm sure all of you know who have been to the ER, they do a second set a couple hours later to see if the troponin (and other cardiac markers) levels are elevated...which apparently indicates a heart attack or that heart damage has occurred. *Correct me if I'm wrong. Those results came back and my troponin level was elevated and they did a 3rd blood draw right way thinking that it could have been a lab error. But, it wasn't.

    Long story short...they sent me by ambulance to a hospital 1 1/2 hrs. from here. They interrogated my ICD, thinking maybe there was a problem there, but nothing irregular showed up. My level was still elevated the next day. My cardiologist originally wasn't concerned that I was having a heart attack and neither was I, since I had a heart cath. 7 months ago when I had the cardiac arrest. My arteries were fine then, but he did another cath. just to be on the safe side. They are still ok.
    My ejection fraction has always been around 55%, but now it's 35% (according the the cath. results). Apparently the damage was done to the anterior wall of the left ventricle.

    I can really tell the difference in how I feel. I am getting so winded again and have less than no energy! And, my Cardiologist still isn't positive what happened. Blood clot, plaque, heart spasm? He wants me to see Dr. Lever, since he has no definitive answers. I have an appt. there in September.

    Has this ever happened to anyone? Anyone have any thoughts on the situation? I guess I have the same age-old question..."to be concerned?" or "not to be concerned?"


  • #2
    Dear Rene',

    I do not know anything about this specifically, but I would be worried. The 20% drop in ejection fraction alone would be enough to get me to a specialist asap. I admire your patience and your willingness to try to relax about this, but frankly, I would not want to wait until September. I suggest you either call Dr. Lever's office and try to get this appointment moved up or call Lisa and see if she thinks you need to be seen sooner. If she does, she may be able to get this appointment moved up.

    Meanwhile I will pray that you get better news next time. Please keep us up to date on what happens and when.



    • #3
      I don't know if this is your specific case. But, I do have elevated troponin levels when I have my chest pain. I don't know how high your's was though my docs said that they weren't worried unless it got above 2.0. For me this is attributed to microvascular disease and spasms.

      I did ask my docs when I could stay home with this pain. And they could give me no guidelines. They said it was a decision I have to make doesn't make me feel comfortable but I am slowly learning when it is bad enough go and when to tough it out.

      I hope this helps.

      Mary S.


      • #4
        Since this is something new for you I would try to get the appointment in Cleveland moved up. There may be something else going on that you aren't aware of. And I agree with Rhoda, the 20% drop in EF would cause me a little concern too. Let us know what happens.


        Husband has HCM.
        3 kids - ages 23, 21, & 19. All presently clear of HCM.


        • #5
          The EJ change is a big concern, I agree.

          As for the troponin level, it is a little known fact that HCM hearts tend to "leak" troponin as all the arrhythmias and/or working too hard creates a heart that appears to have had a heart attack because heart damage (and heart attacks) create dead heart tissue. Heart attacks just usually cause a lot all at the same time while HCM is a slow leak in your tire instead of a blow out.

          Hospitals have not figured this out and there are medical guidelines in place that troponin level based (as in elevated levels guarantee you a 24 hour stay)--I was not allowed to even be moved out of the ER and into a room once b/c my level was a 4 --which they considered an active heart attack --not taking HCM into consideration.


          • #6
            Rene, I have to agree with others here - Sept is a long time to wait when you have such a big change in numbers and are feeling so symptomatic. I hope you are able to move the appt up a bit earlier. Please keep us posted - Linda