Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Elevated Tropinin Levels?
Question: I had elevated troponin it was 44 the dr said it's not high enough for heart attack that should be in the thousands or millions but it was still elevated then six hours later went down to normal under ten and the troponin tests I've had done since then are all under 10 aswell
I guess I'm just curious I was in a packed out cinema and in full blown anxiety attack when I felt the pain shot from my chest down my arm like a lightning bolt then I got the 44 reading, so I'm curious to know if anyone knows if panic attacks and anxiety can elevate troponin levels only for them to return to normal once panic seizes
I had a normal echocardiogram before this elevated troponin test and then had a normal ct scan of the heart after but I'm worried sick now because I have heard I'm now at risk of a heart attack due to the elevated troponin level
I suffer with chest pain, dizziness, blurred vision, left arm pain and left shoulder bladd pain and jaw pain everyday and have done for four months
I cannot sleep due to pain and worry however because my ct scan was normal my gp says my heart is fine and the cardiologist refused a stress test due to it probably being a false positive and that my ct heart scan was normal
I'm so frightened I just want to know if my raised troponin was from panic and anxiety
I guess I'm just curious I was in a packed out cinema and in full blown anxiety attack when I felt the pain shot from my chest down my arm like a lightning bolt then I got the 44 reading, so I'm curious to know if anyone knows if panic attacks and anxiety can elevate troponin levels only for them to return to normal once panic seizes
I had a normal echocardiogram before this elevated troponin test and then had a normal ct scan of the heart after but I'm worried sick now because I have heard I'm now at risk of a heart attack due to the elevated troponin level
I suffer with chest pain, dizziness, blurred vision, left arm pain and left shoulder bladd pain and jaw pain everyday and have done for four months
I cannot sleep due to pain and worry however because my ct scan was normal my gp says my heart is fine and the cardiologist refused a stress test due to it probably being a false positive and that my ct heart scan was normal
I'm so frightened I just want to know if my raised troponin was from panic and anxiety
Brief Answer:
Yes, I have personally seen many such cases ma'am
Detailed Answer:
Hello ma'am and welcome.
Thank you for writing to us.
I have gone through your query and would like you to know that I am here to help.
Troponin levels are used mostly to indicate cardiac events, but it is absolutely true that they can be mildly elevated in cases of anxiety and/or panic. I have personally seen a few individuals (all young women), come in with severe chest pain, breathlessness, etc; showing a normal ECG (EKG) and 2D echo scan of the heart. But with mildly elevated cardiac enzyme levels.
The fact that both your cardiac scan and ECG (EKG) are normal, itself is proof enough that this is not a cardiac event but either a panic attack or an anxiety attack.
Ma'am, as you are still experiencing symptoms that mimic a cardiac event and are quite uneasy and stressed, you should meet a doctor (preferably a psychiatrist), who should initiate treatment of your anxiety or panic.
In my opinion, being a young and healthy woman, your anxiety or panic is only because you are experiencing symptoms that mimic a cardiac event. Stop worrying, I am sure everything is perfectly fine. All your reports and investigations say so, and these cannot both be false-negative. So stop worrying, your only problem is your stress.
Please feel free to write back to me anytime and about anything. I hope you find my response helpful and it puts you at ease. Please do not hesitate to keep in touch, I am always available to help.
Best wishes.
Yes, I have personally seen many such cases ma'am
Detailed Answer:
Hello ma'am and welcome.
Thank you for writing to us.
I have gone through your query and would like you to know that I am here to help.
Troponin levels are used mostly to indicate cardiac events, but it is absolutely true that they can be mildly elevated in cases of anxiety and/or panic. I have personally seen a few individuals (all young women), come in with severe chest pain, breathlessness, etc; showing a normal ECG (EKG) and 2D echo scan of the heart. But with mildly elevated cardiac enzyme levels.
The fact that both your cardiac scan and ECG (EKG) are normal, itself is proof enough that this is not a cardiac event but either a panic attack or an anxiety attack.
Ma'am, as you are still experiencing symptoms that mimic a cardiac event and are quite uneasy and stressed, you should meet a doctor (preferably a psychiatrist), who should initiate treatment of your anxiety or panic.
In my opinion, being a young and healthy woman, your anxiety or panic is only because you are experiencing symptoms that mimic a cardiac event. Stop worrying, I am sure everything is perfectly fine. All your reports and investigations say so, and these cannot both be false-negative. So stop worrying, your only problem is your stress.
Please feel free to write back to me anytime and about anything. I hope you find my response helpful and it puts you at ease. Please do not hesitate to keep in touch, I am always available to help.
Best wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I had the echocardiogram before the elevated troponin but the ct scan after would the ct scan of the heart show any damage if there was any?
I have had abnormal ecgs but I was told they were nothing to worry about and the ecg and troponin test I had done Thursday were normal
My gp said anxiety cannot produce troponin only damage to the heart and he can't explain why mine went from 44. To normal less than 10 in six hours and that's why I'm scared
My symptoms are worse at night they are present during the day but much more severe at night but I have noticed diazapam reduces the severity
I've been told I'm at risk of a heart attack now and I'm terrified I've just quit smoking after 12 years and have a bad diet and palpitations, my heart beats unusually and often skips a beat or feels like it stops then quickly starts again
Can anxiety and panic disorder mimic a heart attack exactly like I am having? Am I in any danger?
I have had abnormal ecgs but I was told they were nothing to worry about and the ecg and troponin test I had done Thursday were normal
My gp said anxiety cannot produce troponin only damage to the heart and he can't explain why mine went from 44. To normal less than 10 in six hours and that's why I'm scared
My symptoms are worse at night they are present during the day but much more severe at night but I have noticed diazapam reduces the severity
I've been told I'm at risk of a heart attack now and I'm terrified I've just quit smoking after 12 years and have a bad diet and palpitations, my heart beats unusually and often skips a beat or feels like it stops then quickly starts again
Can anxiety and panic disorder mimic a heart attack exactly like I am having? Am I in any danger?
Brief Answer:
ECG and scans after event were normal so are you
Detailed Answer:
Hello once again ma'am.
As I mentioned in my previous response, anxiety and/or panic attacks can mimic symptoms of a cardiac condition.
The simple explanation as to why your troponin levels went from 44 to 10 in such a short duration of time is because of the anxiety or panic attack symptoms regressing.
I do not understand on what basis you have been told that you are at a risk of having a heart attack (myocardial infarction), as there are no predisposing factors to that. The only thing I would consider a risk factor is your tendency to panic or get anxious.
I would also like to know what the report of your previous ECGs have been, to better understand your cardiac status.
As for the scans, if at all there was any damage, it would have been picked up by the scans ma'am.
You are a young female, and have nothing to worry about. Stay calm, do not stress or get anxious for anything. Seek medical attention for your anxiety and easily panicky state, and I do not think there should be anything else you need to worry about.
Also, just to be clear an ECG was conducted after the event? And this was found to be normal? If so, then I feel there is absolutely nothing to worry about ma'am. You are getting tensed for nothing, you are fine. You just need some help with your anxiety.
Please write to me anytime you feel anxious about anything, and I shall truthfully explain everything to you with complete transparency. I am here to help always.
Best wishes.
ECG and scans after event were normal so are you
Detailed Answer:
Hello once again ma'am.
As I mentioned in my previous response, anxiety and/or panic attacks can mimic symptoms of a cardiac condition.
The simple explanation as to why your troponin levels went from 44 to 10 in such a short duration of time is because of the anxiety or panic attack symptoms regressing.
I do not understand on what basis you have been told that you are at a risk of having a heart attack (myocardial infarction), as there are no predisposing factors to that. The only thing I would consider a risk factor is your tendency to panic or get anxious.
I would also like to know what the report of your previous ECGs have been, to better understand your cardiac status.
As for the scans, if at all there was any damage, it would have been picked up by the scans ma'am.
You are a young female, and have nothing to worry about. Stay calm, do not stress or get anxious for anything. Seek medical attention for your anxiety and easily panicky state, and I do not think there should be anything else you need to worry about.
Also, just to be clear an ECG was conducted after the event? And this was found to be normal? If so, then I feel there is absolutely nothing to worry about ma'am. You are getting tensed for nothing, you are fine. You just need some help with your anxiety.
Please write to me anytime you feel anxious about anything, and I shall truthfully explain everything to you with complete transparency. I am here to help always.
Best wishes.
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you so much sir your knowledge and understanding have comforted me
I would like to ask you the best route to take in coping with these awful symptoms I have tried breathing exercises and partaking in activities to take my mind off them including yoga, walking, music, tv and reading but nothing works the 'cardiac' pains are still severe
I have also tried cbt therapy which did not help and I'm seeing a chiropractor every week to help with muscle pain
I have tried many anti depressants from setraline mirtazapine amatriptaline and duloxetine but they did not help at all the only thing that remotely works is diazapam but I cannot stay on it long term due to it's addictive nature so I'm worried about what to try next
It is ruining my life, I cannot eat, I cannot sleep for more than an hour or two a night and I daren't leave the house incase I have a heart attack in public
I'm completely exhausted and emotionally drained and in so much physical pain can you recommend a suitable medication got my many troubles?
I would like to ask you the best route to take in coping with these awful symptoms I have tried breathing exercises and partaking in activities to take my mind off them including yoga, walking, music, tv and reading but nothing works the 'cardiac' pains are still severe
I have also tried cbt therapy which did not help and I'm seeing a chiropractor every week to help with muscle pain
I have tried many anti depressants from setraline mirtazapine amatriptaline and duloxetine but they did not help at all the only thing that remotely works is diazapam but I cannot stay on it long term due to it's addictive nature so I'm worried about what to try next
It is ruining my life, I cannot eat, I cannot sleep for more than an hour or two a night and I daren't leave the house incase I have a heart attack in public
I'm completely exhausted and emotionally drained and in so much physical pain can you recommend a suitable medication got my many troubles?
Brief Answer:
Please be patient, we need to find the cause
Detailed Answer:
Hello once again ma'am.
I completely understand how your symptoms must be frustrating and preventing you from living a normal life.
But you must understand that, all the investigations conducted have not reported a diagnosis as yet. Only once a diagnosis is made can we accurately treat you. The pain is only a symptom, and there is no point treating the symptom, as it is always going to be present as long as the cause is present.
I would advise you to conduct elaborate investigations after meeting an experienced doctor, consider treating:
-Anxiety
-Panic
-Depression
-Check for an rule out costochondritis
-Elaborate evaluation to look for other conditions that can cause a presentation similar to yours
-Coagulation profile (to check if any vascular abnormalities could be causing your pain)
-Lipid profile (to check if any vascular abnormalities could be causing your pain)
-Check on coronary arteries (which if blocked even a slight bit can result in chest pain)
and so on.
It might take time to conduct an elaborate evaluation to find the cause, and every abnormality encountered, no matter how small, should be addressed. I request you to speak to an experienced doctor for the same ma'am.
Please do not hesitate to keep in touch with me and update me with all the reports so we can discuss the way forward. I hope and pray we can find the cause soon and help you lead a normal life.
Best of luck ma'am.
Please be patient, we need to find the cause
Detailed Answer:
Hello once again ma'am.
I completely understand how your symptoms must be frustrating and preventing you from living a normal life.
But you must understand that, all the investigations conducted have not reported a diagnosis as yet. Only once a diagnosis is made can we accurately treat you. The pain is only a symptom, and there is no point treating the symptom, as it is always going to be present as long as the cause is present.
I would advise you to conduct elaborate investigations after meeting an experienced doctor, consider treating:
-Anxiety
-Panic
-Depression
-Check for an rule out costochondritis
-Elaborate evaluation to look for other conditions that can cause a presentation similar to yours
-Coagulation profile (to check if any vascular abnormalities could be causing your pain)
-Lipid profile (to check if any vascular abnormalities could be causing your pain)
-Check on coronary arteries (which if blocked even a slight bit can result in chest pain)
and so on.
It might take time to conduct an elaborate evaluation to find the cause, and every abnormality encountered, no matter how small, should be addressed. I request you to speak to an experienced doctor for the same ma'am.
Please do not hesitate to keep in touch with me and update me with all the reports so we can discuss the way forward. I hope and pray we can find the cause soon and help you lead a normal life.
Best of luck ma'am.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
