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Troponin test
TroponinI; TnI; TroponinT; TnT; Cardiac-specific troponin I; Cardiac-specific troponin T; cTnl; cTnT
A troponin test measures the levels troponin T or troponin I proteins in the blood. These proteins are released when the heart muscle has been damaged, such as occurs with a heart attack. The more damage there is to the heart, the greater the amount of troponin T and I there will be in the blood.
How the Test is Performed
A blood sample is needed.
Blood sample
Venipuncture is the collection of blood from a vein. It is most often done for laboratory testing.
How to Prepare for the Test
No special steps are needed to prepare, most of the time.
How the Test will Feel
You may feel slight pain or a sting when the needle is inserted. You may also feel some throbbing at the site after the blood is drawn.
Why the Test is Performed
The most common reason to perform this test is to see if a heart attack has occurred. Your health care provider will order this test if you have chest pain and other signs of a heart attack. The test is usually repeated two more times over the next 6 to 24 hours.
Your provider may also order this test if you have angina that is getting worse, but no other signs of a heart attack. (Angina is chest pain thought to be from a part of your heart not getting enough blood flow.)
Angina
Unstable angina is a condition in which your heart doesn't get enough blood flow and oxygen. It may lead to a heart attack. Angina is a type of ches...
The troponin test may also be done to help detect and evaluate other causes of heart injury.
The test may be done along with other cardiac marker tests, such as CPK isoenzymes or myoglobin .
CPK isoenzymes
The CPK isoenzymes test measures the different forms of creatine phosphokinase (CPK) in the blood. CPK is an enzyme found mainly in the heart, brain...
Myoglobin
The myoglobin blood test measures the level of the protein myoglobin in the blood. Myoglobin can also be measured with a urine test.
Normal Results
Cardiac troponin levels are normally so low they cannot be detected with most blood tests.
Having normal troponin levels 12 hours after chest pain has started means a heart attack is unlikely.
A normal value range may vary slightly among different laboratories. Some labs use different measurements or test different samples. Also, some labs have different cutoff points for "normal" and "probable myocardial infarction." Talk to your provider about the meaning of your specific test results.
What Abnormal Results Mean
Even a slight increase in the troponin level will often mean there has been some damage to the heart. Very high levels of troponin are a sign that a heart attack has occurred.
Most patients who have had a heart attack have increased troponin levels within 6 hours. After 12 hours, almost everyone who has had a heart attack will have raised levels.
Troponin levels may remain high for 1 to 2 weeks after a heart attack.
Increased troponin levels may also be due to:
- Abnormally fast heart beat
-
High blood pressure in lung arteries (
pulmonary hypertension
)
Pulmonary hypertension
Pulmonary hypertension is high blood pressure in the arteries of the lungs. It makes the right side of the heart work harder than normal.
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Blockage of a lung artery by a blood clot, fat, or tumor cells (
pulmonary embolus
)
Pulmonary embolus
A pulmonary embolus is a blockage of an artery in the lungs. The most common cause of the blockage is a blood clot.
Read Article Now Book Mark Article - Congestive heart failure
-
Coronary artery spasm
Coronary artery spasm
The coronary arteries supply blood and oxygen to the heart. Coronary artery spasm is a brief, sudden narrowing of one of these arteries.
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Inflammation of the heart muscle usually due to a virus (
myocarditis
)
Myocarditis
Myocarditis is inflammation of the heart muscle. The condition is called pediatric myocarditis when it occurs in children.
Read Article Now Book Mark Article - Prolonged exercise (for example, due to marathons or triathlons)
- Trauma that injures the heart, such as a car accident
-
Weakening of the heart muscle (
cardiomyopathy
)
Cardiomyopathy
Cardiomyopathy is disease in which the heart muscle becomes weakened, stretched, or has another structural problem. It often occurs when the heart c...
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Increased troponin levels may also result from certain medical procedures such as:
- Cardiac angioplasty/stenting
-
Heart defibrillation or
electrical cardioversion
(purposeful shocking of the heart by medical personnel to correct an abnormal heart rhythm)
Electrical cardioversion
Cardioversion is a method to return an abnormal heart rhythm back to normal.
Read Article Now Book Mark Article - Open heart surgery
- Radiofrequency ablation of the heart
References
Anderson JL. ST segment elevation acute myocardial infarction and complications of myocardial infarction. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 73.
Levine GN, Bates ER, Blankenship JC, et al. 2015 ACC/AHA/SCAI Focused update on primary percutaneous coronary intervention for patients with ST-Elevation myocardial infarction: an update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention and the 2013 ACCF/AHA guideline for the management of ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. Circulation . 2016;133(11):1135-1147. PMID: 26490017 www.ncbi.nlm.nih.gov/pubmed/26490017 .
Sabatine MS, Cannon CP. Approach to the patient with chest pain. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 50.
Tehrani DM1, Seto AH. Third universal definition of myocardial infarction: update, caveats, differential diagnoses. Cleve Clin J Med . 2013;80(12):777-786. PMID: 24307162 www.ncbi.nlm.nih.gov/pubmed/24307162 .
Review Date: 10/6/2015
Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
