Hi,
I'm trying to understand if troponin levels mean anything?
I've read that they indicate a heart event but is there a scale of troponin levels vs structural damage to the heart?
Or is troponin just an indicator, ie l a light bulb coming on indicates the presence of electrical currents but not how much current is flowing.
thanks baly
nbt.nhs.uk/sites/default/fi...
Above is a clinical guidance sheet explaining the levels. It's an indicator of heart muscle damage or scarring most frequently caused by an ischaemic heart failure/attack as I understand it. But scarring and raised troponin levels can also be caused by other events too. I am currently in hospital and the first tests showed very elevated troponin levels which drive an early decision of a heart attack. However as well as being symptomless, IE no chest pain etc subsequent echocardiogram, angiogram and MRI have shown no structural problems with my heart or blood vessels. Hope it helps
that's very useful thank you
Troponin is released when the heart muscle is damaged or injured.
Infection, eg c**id,
inflammation eg myocarditis.
Lack of blood supply,
Arrthymias such as atrial fibrillation, high or low heart rate.
heart failure,
takostubo syndrome
pulmonary embolism,
trauma,
renal failure
extreme exercise like running a marathon.
A raised troponin level has to be evaluated in the context of the person's clinical history such as symptoms of angina and dynamic ECG changes.
thank you so the key words are damaged ( potentially irreversible) or injured ( can be nursed back to normal state).
Yes,I have had myocarditis in the past.
It has left a small patch of scarring on my heart which is seen whenever I have a cardiac MRI.
Troponin should be non existent or negligible unless your heart is damaged. I think 40 Reading indicated a heart attack but I was in the mid 30s when I had mine - probably as I went to the hospital too late
Hello - when I had my heart attack in November 2023 my troponin levels were over 100,000 and was told that this was extremely high and subsequently blood taken as part of a study.From what I can gather from asking doctors etc they did seem very concerned.
Regards Flag2
Gosh, that is very high. Mine was >25,000 by the time I’d reached the cath lab for a stent. On A&E admission it was around 500 so climbed quite dramatically. How much damage did your heart suffer, if you don’t mind me asking?
I'd just like to add my experience, which should add some more flesh to what Chinkoflight and Milkfairy have said.
I was admitted to A&E after a sustained polymorphic VT event that almost degraded to cardiac arrest. (INFO: If you are new to all the lingo🤷, sustained polymorphic ventricular tachycardia is a life-threatening heart rhythm.)
So this was not a MI/heart attack, but on admission the duty cardiologist said that my bloods exhibited the fingerprints of a infarction (i.e. heart attack), due to my rising troponin levels. This wasn't my home hospital and they weren't taking any chances. I was given a chest x-ray as a precaution (standard procedure, apparently?) in addition to multiple ECGs. I was subsequently given the all-clear re a heart attack and transferred/admitted to my usual sports cardiology team who were able to look at the data from my implanted loop recorder and confirm that it had been a VT.
One of the registrars explained that there is ongoing debate amongst cardiologists about looking at elevated troponin levels in isolation. She told me to view it as a flag that the heart has experienced a high stress/traumatic event, with possible damage or scarring, rather than an absolute indicator of damage. She labelled it as a stress response. I found this to be a helpful explanation, hence wanting to share it with you.
I hope this helps. Good luck! 🙂
Thank you for that very informative reply, hope you are doing well now 
Well, I am much more under control now (in more ways than one! 😆), having been diagnosed with ARVC. It's a congenital condition which had been completely hidden until that episode. So, whilst I will never have a healthy heart nor be able to run/ski again, it is a sheer pleasure to wake up each day and celebrate life. It could easily have been a different outcome.
Here's to surviving and being able to talk to each other! 😃🥂
Hi EmmJay, that's such a helpful answer. I am in now for 38 days after an exercise syncope event while running a Parkrun. Described as running into the ground by those behind flat on my face. So x-rays for skull fractures/ bleeds etc. But I have an ILR too and when the EP team were in on Monday turned out to be a 23 second LVT. Raised troponin levels in the bloods so first diagnosis you've had a heart attack, but I was completely symptomless until about 3 seconds before I blacked out. Never had such an event before although had a previous stroke also symptomless. The stroke and now the 'HA ' event including detailed echocardiogram, angiogram show no ischaemic issues at all and no co-morbidities.So reluctantly they agreed that more investigations were needed. A specialist cardio MRI in the regional hospital pointed to either an embolic or non ischaemic cause although scarring is seen on the LV. So I'm awaiting the results of a special PET scan, again in a regional centre to look for a possible sarcoid or other cause.
I've done lots of reading in the 38 days in my local CCU and also have found the references to troponin levels not always linked to a HA. Nevertheless some but not all the consultants I've seen are willing to say well it's a silent HA then! It's the easier diagnosis because they will fit either an ICD or CRT-D device, a bit fit and forget it feels like. As I said to one consultant " aren't you curious?".
Eek! Sorry to hear about the Parkrun drama and I hope you didn't get trampled on. 😬 I had a few few (pre-)syncope running events last year and quite agree that you get very little warning.
You are in the best place for investigations now, although it does sound a bit like you are working your way through different types of scans there! I do hope that curiosity takes hold and they find the root cause of your recent VT. And if you end up with an ICD, you'll be joining the club! 🙂 Take care, good luck and hang on in there.
I think this was meant for someone else ? It's Monday morning lol
Dont know what they mean but when i arrived at A&E mine was 36 then a hour later they took more blood was 88 thats when they told me it was a heart attack then sat in A&E for another 29 hours waiting for a bed then stent fitted 72 hours afte first arriving so wasnt that bad i think .
Yes, it is the trend from hour to hour that they are particularly interested in, rather than a snapshot reading. This helps to identify possible heart attack markers. This is what was explained to me.
Hi Baly
I had a STEMI heart attack in September 2023, I was a late presentation, my Troponin was 9500, which I really don't understand, I think I have slight damaged a slow pump on a ECG, my echo showed a good EF, like 55 %., but no heart failure. Still trying to get back to normal life, not back at work, and after 6 months, and I really feeling much better within myself.
Hi baly_2023
After my STEMI my Troponin I was measured at 95 ng/mL with the normal range being 0.4 ng/mL, though the Medics didn't need this per-say as the ECG clearly showed the STEMI.
Not really sure if this helps, just shows a shed load of heart enzymes released afetr HA.
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