Patients who present in the emergency room with chest pain are given a troponin test (blood sample is taken by nurse).

Troponin is a protein enzyme that leaks from the heart when this muscle is damaged.

If the test result is elevated (in a range that indicates damage to heart tissue), this can mean that the patient had a heart attack very recently.

However, elevated troponin doesn’t always mean cardiac damage.

In fact, the test result isn’t either normal or elevated; there is another range — an in-between range.

It’s sometimes referred to as a gray area or indeterminate area, which (along with elevated status) warrants a follow-up blood draw several hours later to see if the result is of a higher value (meaning that even more troponin has leaked from the heart).

If elevated troponin doesn’t always mean damage to the heart, what else might it mean?

“It can mean a long list of non-cardiac things, the most common being from renal failure, heart failure, pulmonary embolus, cardiac contusion, sepsis, cardiotoxins, CNS disorders, excessive exercise,” says Dr. Sameer Sayeed, a cardiologist at ColumbiaDoctors of Somers, NY.

Other causes of elevated troponin not related to the heart muscle include: high blood pressure, drug toxicity, low thyroid, transient ischemic attack, stroke and rheumatoid arthritis.

Dr. Sayeed performs echocardiograms and stress tests at the Midtown Manhattan and Westchester offices at Columbia Doctors. He is also trained in cardiac CT imaging.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  
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