Ask a doctor on the topic of Internal medicine

Troponin value and heart failure

February 4, 2017 | 25,00 EUR | answered by Dr. med. Frauke Gehring

Hello Mrs. Höllering, I am almost dying of fear. During my examinations, the Troponin levels were strongly elevated and rising, with a BNP value of 236. No one addressed the heart failure. This was ruled out by heart ultrasound and MRI.

Dear Sir or Madam,

I was admitted to the hospital on Tuesday. Troponin level at 7:45 am = 107 and ck level 53. Suspected heart attack. Blood 6 hours later showed Troponin: 97. Heart ultrasound and CT scan of the lungs were performed: no findings.
24 hours later, Troponin level was 132 (rose again after dropping).
The following day, a cardiac MRI was performed with findings of no myocarditis and no ischemia. By the third day, my Troponin level was within normal range: 23 and ck level: 6.3 (almost normal).
Today, after three days, I was discharged with the following finding: unexplained Troponin increase.
No cardiac catheterization was performed. I am now afraid that I had a heart attack but did not undergo catheterization for a stent. My only symptoms over the days were tachycardia. No pain. Before the incident, I had a severe case of tonsillitis, but myocarditis was ruled out. Does this sometimes happen with other patients as well? I am a 36-year-old female.

Dr. med. Frauke Gehring

Good day,

You have personally addressed me, although I have already written you everything important before. I will do it differently now: A heart failure would definitely have been seen in the ultrasound, a coronary heart disease in the MRI. However, in both cases, the troponin would not have immediately decreased. These are chronic problems. I wrote to you that, for example, tachycardia can cause such an increase, and then you wrote that you had one. That is a logical explanation, especially because after the end of the tachycardia, the value returned to normal. Your fear is the problem, not your heart.

Warm regards, Dr. Höllering