Heart attack caused by AF episode?

[ralft]

I had a very mild heart attack while hospitalized for an extended AF episode. I went to the ER after I detected an episode 1st thing in the morning. I went in only because I feared it might have started while I was asleep as much as 7 hours earlier.

My cardiologist seemed to think it strange to have an attack while I was hospitalized. He assured me it was mild because of the very low Rapid troponin1 levels. Measurements started at 0 and subsequently .01 & .09 ng/ml. I never had chest pain or any pain.?

Have other readers had a heart attack while hospitalized

[BobD Volunteer]

Frankly I doubt that you did have even a mild heart attack and surprised that the doctor suggested that. Raised troponin levels are not uncommon with AF in some people as I am sure others with personal experience will confirm . Doctors don't always know everything!

[Buffafly]

I was sent to hospital by my GP because of AF with chest pain etc and was kept in for three days and had an angiogram because of raised troponin levels but no clot was found. A subsequent ECG showed 'possible MI' and cardiologist didn't say either way but suggestion was artery spasm. So it can be a bit of a grey area. Even if you did have a tiny heart attack I can't see why you shouldn't have it while in hospital though I would agree with Bob.

[Adiepie in reply to Buffafly]

Me too, stayed for 6days with raised troponin,ablation 18 months later, due for my next ablation shortly. Records say minor MI, but no clot on angiogram

[whiststev]

Hello,

I had a very fast heart rate AF attack some time ago which lead me to go to A+E,Although it was rare for me to have this type of episode,also thinking it might be something else like an MI the Dr checked my troponin levels which were slightly raised and informed me that they can be slightly raised when a person has a rapid heart rate episode ,like Bob confirms .ECG confirmed no MI.Hope this help

Steve

[Amcech]

I had an ECG in the ER while in AF and the doc reading said evidence of old MI. Had a repeat ECG 2 weeks later that was perfectly normal and showed no evidence of MI. I think ECG can be difficult to read when in full blown AF for some docs, not cardio.

[JonathanPittsCrick]

I agree with BobD and the others: rapid AF can cause a troponin rise suggesting a "small heart attack" and the ECG can be unreliable also in this situation as Buffafly says, with temporary changes of angina. This is due to timing: the heart muscle only gets oxygenated blood during the relaxation between beats and when the AF goes very fast there is not enough relaxation time for this to happen and part of the muscle near the inside can get almost no oxygenated blood at all. This is when it releases troponin which is picked up on the blood test (though at a much lower level than with a typical blocked-artery-type heart attack). Usually it recovers with no lasting damage but it can upset the heart function for a few days afterwards.

The other possibility is a virus affecting the heart (myocarditis) which causes inflammation and can put up the troponin as well as triggering an attack of AF. Again, this usually gets better with no after-effects but it can take longer and sometines leaves a scar that can be detected on a cardiac MRI scan.

[BobD Volunteer]

Listen to the man above and google him. Then relax.