Troponin is one of the proteins in heart tissue. When heart tissue is damaged for any reason the troponin will be released into the bloodstream and can be measured by blood tests. Troponin can be elevated by several conditions. Acute myocardial infarction (heart attack) causes significant elevation of the troponin. Troponin can also be elevated by other heart conditions like a fast heart rate (tachyarrhythmia) even if there are no blockages in the blood vessels. The reason for this is an imbalance in supply of blood to heart tissue and the demand of the heart tissue. For some people, heart rates around 148 strains the heart because of imbalanced supply and demand, therefore the troponin can be elevated. Significantly elevated blood pressures (hypertensive emergencies) can also cause elevations in the troponin by similar mechanisms, because the heart must work hard to overcome such high blood pressures. Troponin can be also elevated with a pulmonary embolism, myocarditis, renal failure, sepsis and some other rare causes. Therefore troponin should be interpreted with the clinical context in mind and the degree of troponin elevation. Heart attacks and myocarditis usually produce the most significant elevations in troponin. The other causes usually do not elevate the troponin by much and are sometimes referred to as a troponin leak. In your husband s case, the elevated troponin was probably secondary to imbalanced supply and demand related to the fast heart rate and/or elevated blood pressure, since his coronary arteries were clear. Vasospasm of the coronary blood vessels can also lead to heart damage by narrowing the blood vessels supply the heart for a period. Vasospasm usually occurs in patients with blockages in the coronary arteries. Discuss this with your husband s doctors, because they know the full details of his medical issues. Good luck.