So when I was at hospital for the chest tightness they only ran 1 troponin about 3 hours after I arrived and it came back negative <3mg/l hs-cTnT
However I’ve read on here people get multiple but the doctor and cardiologist consult discharged me is that normal? Do I need a second one it’s been 36 hours since the pain started now but the tests were negative. But idk if I need another troponinz
That's helpful for my peace of mind aswell Joe! 😅
Yh like they tested mine about 4 hours after the pain started but I assume there would have been atleast something come up abnormal in that not just <3mg/L
The interpretation of in particular high sensitivity troponins levels in the blood is changing.
Prof Nick Mills, a BHF funded researcher found that if a person's blood troponin was less than 5ng/L it was highly unlikely that they could be having a heart attack.
It has been shown patients with a troponin blood level 5ng/L or below can be safely sent home.
ahajournals.org/doi/full/10...
I have my troponin blood levels checked fairly often. The phase Cardiologists tend to use is that troponin blood levels are reassuring rather than negative.
ah ok so the 3/4 hours after the onset they did bloods and it being <3mg/L is good then.
This is great to have thanks for sharing! 👍😀
Been through all these pathways more than once. Been dosed with anticoagulant too prior to being admitted to cardiology ward just in case, especially when they weren't sure where things were heading.
I have to admit troponin does baffle me. When I went a and e they done one blood test and the troponin just came back with a figure of 26.2 no info of what it was measuring. I just had one blood test and was sent home. My nurses said the figures where fine. So I assume it was below the 34ng as they state in the Oxford Radcliffe guidance. But it still baffles me all this. But it does depend on the test machine they use. .?
I agree it can be confusing. Each hospital will have it's own reference levels according to which manufacturer's laboratory test they are using.
Also dependant on if they are measuring Troponin I or T.
Using High sensitivity troponins have been introduced in the last few years.
The levels are different for men and women.
You can have raised troponin levels due to other reasons not just heart attacks.
Then the latest research is suggesting there is a grey area of between 5ng/L and 16ng/L for women, 35ng/L for men which seems to be associated with an increase chance of the person experiencing a major adverse cardiac event in the next year.
Yes I think ours use the 35ng/L for men and 16ng/L for women. It's just so frustrating be because we are interested in our data. And wish to keep our own eye on them. But if they send you home and they are happy you have go along with it.
Very interesting especially as I am sat in Wigan A&E waiting for results of second test. I was blue lighted here 10 hours ago and had bloods taken quickly but only saw doc 30 minutes ago. They said first troponin test was fine but their procedure is to always do a second test and take a chest X-ray.
Yh my symptoms kinda have stayed the same. Just a crap situation, being 21 makes me question it a lot. But the cardiologist gave me a proper look and checked me over.
It's reassuring as you have been seen by a Cardiologist who will have been able to assess that it was okay to send you home.
Perhaps make an appointment with your GP and discuss how you're feeling with them?
yeah I will, they don’t really take me seriously with the amount of testing I’ve had done tbh. They won’t give me a ct angio due to my age and they find it pointless so it’s basically. Ahhhh it’s anxiety.
Hidden has given you a good understanding. The same Troponin which was measured for you is also measured for me when I end up in A&E with chest pain. However, I have had two instances where my Troponin was tested twice a couple hours a part despite the first one being negative. I believe the reason they do this with me is I have either had a bad month, where I’ve taken 2 trips to A&E for example with the same symptoms, so they perform an additional one to be safe and, because I have a proven record of a heart condition and diagnosis.
I know it’s frustrating, but I remember in my early days before my diagnosis, they would only check my Troponin once and I would be sent home if it was clear. That protocol is normal and despite going home with the same symptoms, I didn’t have a heart attack. So please be assured that a negative Troponin test is a very good thing!
As a group of patients those of us living with vasospastic angina do not fit easily into the usual protocols for obstructive coronary artery disease. The usual acute coronary syndrome protocols do not necessarily meet our needs.
As, I have a confirmed diagnosis of vasospastic angina with an agreed careplan in place, I am always admitted for treatment with IV GTN, 17 times so far in 11 years.
My coronary vasospasms are treated rather than my troponin blood levels. I am never sent home in pain. My Cardiologist insists I stay as long as it takes to settle my coronary vasospasms which is usually 8 days.
When I had my trop test my results were elevated so they did a further test 4 hours later and the results were again elevated and had gone up massively. If your results were negative why would they do a further test. To me that's a good thing.
They do a repeat test depending upon when the pain started, and can then judge whether a heart attack is evolving or not. Essentially within the first 6-8 hours of a heart attack the enzymes released that trigger the rise in TNI are not sufficiently reliable. They like 2 or 3 serial indicators over that period to be sure. After 6 or more hours TNI levels stay raised for up to weeks if you've had a heart attack. But note TNI levels can be above thresholds because of other factors like Myocarditis, excessive endurance exercise and so on. EDs face a tradeoff between keeping you there and testing for no good reason versus sending you home too soon when something's actually wrong.
Hi. If your troponin level was a little higher say 8 they would probably wait a few hours then do another test to make sure the value hasn't increased. At lower than 3 it's fine for 1 test.
Yh they said anything above 6 they will just recheck to be sure and the doctor said a lot of heart attack hit into the 100s and higher. So they weren’t worried with <3. It’s never been higher than 4 in all my blood tests. I think just anxiety has got by the teeth
you’re meant to have one done when you get in as the baseline, and another one 2 hours later to compare it to. If the latter is lower, your go home.
I had one test, told levels were over 4000 so definitely had experienced a HA but no second test was done. Seems each hospital may have their own protocols
I have always had three tests, about 3 hours apart. Oddly, one time a doctor said they had a new system where only one blood test was needed, however since then I've always had three. So who knows......? (It's usually the second blood test that's the highest - in my experience anyway.)
I should say that I have never had a heart attack as such, but takotsubo cardiomyopathy. which in the acute phase, can mimic an MI. The first test is often within normal limits, next raised, third a bit lower but not back to normal.
Hi,I guess it must vary depending on where you live?? I have always had 2 lots if bliidctests done for troponin levels.
They took 3 tubes of blood but initially only did one blood test I don't think any tropinin was detected because they just said bloods are fine so that was a relief I wonder what else they were looking for 🤔.
Just out of interest how long does tropinin levels stay in the blood stream. I had pain in arm at 10 and got to A&E bout 9.15 at night lol and got seen at midnight finally had blood test at bout 1 something so could it have not been in my system by then?? Sorry just wondering if I had got there sooner would it have made a difference 🤔😕
Aw brilliant! 😅 Phew! Just thought I'd ask thanks for clearing that up for me Joe 😄😁😉.
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