Raised troponin

[Egghead68]

Went to A&E last week with fast heart rate, breathlessness and chest pain (I am getting over a virus).

They said my (brief) ECG was normal but my troponin was elevated to ‘5’ which was stable across repeat testing a few hours later. They agreed I was tachycardic.

Does anyone know what this might mean please? I am worried about mild myocarditis.

Anyone? Any doctors know what this might mean please?

Troponin is an enzyme your heart releases when in distress.

Normal levels are generally considered to be below three, but if the drs said they are happy with a stable level at 5, take their word as it is.

I took someone to A&E today with a raised level at 48, and they're just monitoring at the moment - they do angiograms and get twitchy if the reading is in the hundreds/thousands

Tachycardic just means that your heart is beating quicker.

As @zombiepara said it's a enzyme released when heart muscle is damaged or under stress. Elected troponin levels often indicate a heart attack but can also be caused by other issues such as tachycardia

If your ecg was normal then it prob isn't a heart attack

Have you had rapid heart beat before? I'm sure it isn't pericarditis or endocarditis- prob viral response but straight to A and E if it happens again

Many thanks @zombiepara. The doctors didn’t say they were happy with the level. They said to ask the GP for an echocardiogram if my tachycardia and chest pain did not settle.

@whitegrenache I don’t think I’ve had a rapid heart beat before except when exercising.
My heart rate has come down a little since last Friday but is still higher for me (around 85 resting and 105 if I walk around very slowly. It used to be around 70 when resting). I get chest pain after walking around.

I think I’ve had a virus (Covid-19 specifically, but no tests were available) but the junior doctor was keen to put it all down to anxiety, at least initially (I’m really not convinced).

I forgot I did have POTS some years ago but don’t think I’ve had a fast heart rate at rest before.

@Egghead68 apologies, i mistook that as the doctor being happy with it all.

Does the pain settle when you rest?

Is it only ever on exertion? Or does it come on at rest too?

Did they try a little spray under your tongue?

We consider 60-100 beats per minute to be in normal range, albeit on a different scoring system, over 90 is a sign of infection.

It could all be connected to getting over the virus, or it may be something more, hence requesting the echo

Thanks @zombiepara and @whitegrenache for your answers. I really appreciate your knowledge and time.

I get some pain at rest intermittently but it is a lot worse with exertion.

They didn’t try the spray.

My heart rate was around 130 at rest (a week ago) although this has now improved to a maximum of 105.

I think this must be somehow related to the infection (I was very fit and my heart was very healthy prior to this).

There are cases of Covid causing myocarditis which is what is concerning me as I think I should be on bed rest if that is the case (I understand mild cases of myocarditis don’t always show on short ECGs). The junior doctor I saw couldn’t rule this out but understandably said they just don’t know much about post-covid effects yet.

So something we look for with infection (bacterial or viral) is a raised heart rate - it's a pretty universal sign, along with a temperature etc.

Obviously as your body starts to heal it will begin to go down and return to normal for you, which is what it sound like is happening, which is good.

I can't really comment on the myocarditis with regards to Covid, simply because we don't know enough about it, and my protocols are very different to those in the hospital.

Are you experiencing any shortness of breath at all?

On a personal note rather than "job head" as it were, I'd say to take it easy for sure - I wouldn't suggest as far as bed rest (unless you feel this is what your body is telling you) but definitely don't over exert yourself.

And if you feel at any point you are getting worse rather than better (remember, you may plateau out for a bit whilst recovering) then call for further help.

Chest pain is a tricky thing in "normal days" let alone at the moment, but the echo should definitely help on the way to looking at the function of your heart and seeing if there are any mal-effects on it from being unwell.
Did they say how long it would be before your appointment, or was it a general "we've referred and you'll hear at some point"?

Thanks so much @zombiepara.

I do get intermittent shortness of breath on minimal exertion e.g. making a hot drink or talking.

They haven’t referred me for the echo cardiogram. They said to ask my GP for one if my symptoms (tachycardia, chest pain, shortness of breath) don’t settle.

I’m taking it very easy except for 1000 very slow steps round the house each day.

Thanks so much for your help. It’s easy to feel very alone and ‘at sea’ with these symptoms. I really appreciate your input.

@Egghead68 not a problem! Happy to help!
I'd say see how you are Monday, and give your doctor a call anyway - just keep them in the loop, explain your concerns over the phone and that the other Dr said about a potential echo - can they please action this.

They may give you a more specific time frame, where they say after which to be concerned and get in contact again. In itself that would help with reassurance as it gives you something solid and specific to work within!
Or they may just make the referral, you never know 👍🏻

Will do - thank you again.

Just to update, GP sent me back to A&E yesterday who confirmed that tachycardia and mildly raised troponin were ongoing. She has now referred me for an urgent 24-hour ECG and echocardiogram. She said this may take some time to come through so I will consider going privately if necessary. Thanks again for all your help.

Hi @Egghead68
Did you manage to get to the bottom of it?
I'm having similar problems and wondered how you go on with echo

Hi - they sent me a copy of the echo report but I couldn’t open it. I’m assuming it was ok. The sonographer(?) said it looked “pretty normal” at the time.

I got an invitation for another one at a different hospital but I think it was a mistake and it got cancelled anyhow due to covid.
I still have a raised heart rate and started getting chest pain again after a covid jab,
I’m assuming it’s POTS.
Hope you get to the bottom of yours.

Just tagging you @OneTwoStep