High troponin: what it means and what to do

A high troponin means the heart muscle has been damaged. The first thing to rule out is a heart attack. If you have chest pain, breathlessness or feel faint, call 112 straight away. A doctor reads the value, together with your symptoms and an ECG.

What high troponin means

Troponin sits inside heart cells. If it is above the lab’s limit, some cells have been under strain and let it out into the blood.

The doctor looks at how it changes. If it rises or falls within hours, the damage has just happened, as in a heart attack. If it stays high and stable, the damage is often slow, as with kidneys that work less well or heart failure.

A high troponin is not a diagnosis. It says your heart needs checking, and the cause needs to be found.

What causes high troponin

The first is the most important to rule out. The others are common.

Symptoms of high troponin

A high troponin on its own causes no symptoms. Symptoms come from the cause. In a heart attack, for example:

If you have these symptoms, call 112 or go to the emergency department. Do not drive yourself.

High troponin without a heart attack

This is common, especially in older people, people whose kidneys work less well and people with heart failure. In these cases troponin is usually only a little high and changes little between two tests.

It can also rise for a few days after very long exercise, then return to normal.

It is still not a detail to ignore. Even without a heart attack, heart damage needs to be understood: your doctor looks for the cause and decides whether you need more tests, such as a heart scan.

Which tests to read alongside it

In hospital, the doctor reads it together with these tests.

What to do if your troponin is high

It depends on how you feel right now.

Your doctor decides whether to repeat the test, do an ECG or other tests. Do not try to interpret the value yourself.

High troponin: when to worry

Call 112 or go to the emergency department if you have:

Frequently asked questions

Is high troponin always a heart attack? No. A heart attack is the most important cause to rule out, but heart failure, an embolism, inflammation of the heart, kidneys that work less well and very hard exercise can raise it too. A doctor decides.

High troponin without chest pain: what does it mean? That the heart has been under strain for another reason, or that a heart attack gave different symptoms, which happens more often in women, older people and people with diabetes. Talk to your doctor the same day.

Can high troponin come from the kidneys? Yes. People whose kidneys work less well often have a slightly high, stable troponin. Your doctor compares it over time to see whether anything is new.

High troponin after a marathon: is it normal? It can happen in healthy people, and it usually returns to normal within a few days. If you had chest pain, breathlessness or fainting during the effort, see a doctor straight away.

How long does troponin stay high? After a heart attack it can stay high for several days. After hard exercise it usually falls faster. Your doctor decides when to check it again.

Sources