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The heart is one of the most important organs in the body. When something goes wrong with the heart, the effects can be life-threatening. One of the key tests that doctors use to detect heart damage is the troponin test. But what exactly is this test, what does it measure, and what do the results mean?
Troponin is a protein that is present in heart muscle cells. If the heart is healthy and normal, troponin in the bloodstream will be extremely low or not undetectable. When the heart muscle is injured, e.g., during a heart attack, troponin leaks into the blood.
The troponin test is a blood test for the level of troponin in the blood. It is used to help physicians determine if there was damage to the heart muscle. This test is used most frequently in the emergency room when a patient presents with chest pain or other symptoms that may be indicative of a heart issue.
There are two predominant types of cardiac troponin that are measurable:
Both of these proteins only occur in the heart muscle, and therefore they are extremely specific to heart injury. The test can examine either one, depending on the lab and the technology being utilized.
The normal range for troponin may be slightly different depending on which lab is doing it, how it is being tested, and whether a high-sensitivity troponin test is utilized. General reference values are:
If your troponin levels are within this range, it usually indicates that there has not been major damage to your heart.
When the heart muscle is injured, it makes troponin appear in the blood, causing it to be higher than usual. A raised troponin level is a strong indicator that something abnormal is going on with your heart. In the majority of instances, very high troponin levels are linked to a heart attack.
But an elevated troponin level does not necessarily equate to a heart attack. There are cases where elevated troponin levels can result from other conditions, including:
For this reason, physicians never make a diagnosis based on the troponin test alone. They also take into account your symptoms, medical history, ECG (electrocardiogram) findings, and other tests to make a complete diagnosis.
In the case of a heart attack, blood supply to the part of the heart muscle is interrupted. Due to this, the heart tissue in the region gets damaged or dies, leading to the release of troponin into the blood.
Troponin levels usually start rising within 3 to 6 hours of the onset of the heart attack. They usually peak at 12 to 24 hours, and may stay elevated up to 1 to 2 weeks after the incident.
Physicians can do serial troponin, which is they check your blood more than one time within a few hours. This is so that they can look at the trend or pattern of your troponin. Having a rising trend is a very strong sign of ongoing heart damage.
At times, troponin is only slightly higher than in the normal range. This is perplexing. It doesn't necessarily imply you're having a heart attack, but it does indicate your heart could be stressed or strained.
If your levels are just slightly elevated, your physician will probably order additional tests or watchfulness to ascertain the specific reason. It is not wise to get anxious but also not wise to brush this off.
If your troponin test is normal, it usually indicates that there is no important damage to the heart muscle when you have the test. This is a positive indication, particularly if you are not experiencing any symptoms of a heart issue.
But there are instances where an individual or patient may be experiencing a heart attack, yet the troponin levels are normal because it is too early to be able to detect it. In this case, physicians will have the test repeated after several hours to determine if the levels begin to rise.
It can also occur due to other reasons, including acid reflux, muscle strain, or anxiety, which would not result in an increase in troponin.
There has been a movement in recent years in which most hospitals have adopted high-sensitivity troponin tests. These tests are more sensitive and can measure much lower concentrations of troponin in the blood.
High-sensitivity tests enable physicians to:
Since they are more sensitive, these tests can also register slightly elevated baseline levels among healthy individuals. That is why medical expertise is needed in interpreting the results.
Troponin tests are typically performed during emergencies when a person is having:
These signs may be an indication of a potential heart attack or other critical heart condition. The troponin test allows physicians to rapidly find out if the heart is involved and make necessary immediate treatment.
The test is easy. A nurse or technician takes a small sample of blood from your vein, generally in your arm. The blood is processed for analysis in the laboratory.
You do not have to fast prior to testing. Results may be returned in one to two hours, and urgent situations are given priority for quicker turnaround.
More than one sample will often be taken in many situations over 3 to 6 hours to see how your troponin level fluctuates. This assists in verifying if there is a continued injury to your heart.
Troponin levels are not something that you can reduce directly with medication or diet. They are indicative of heart injury, not causative.
Treatment is directed at the root cause of what led to heart damage. For instance:
Once healing in the heart begins, troponin levels will slowly decline by themselves.
Troponin tests are strong tools that enable physicians to detect and track heart damage. Knowing what the test measures, what the normal range is, and what various levels indicate can help you better understand your heart condition.
A high troponin level is worrisome but doesn't necessarily indicate a heart attack. Only your physician can offer an accurate interpretation based on your general health and symptoms.
If you ever have chest discomfort, shortness of breath, or other symptom warning signs, get medical attention right away. Early treatment and testing can save lives and decrease the chance of permanent heart damage.
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