Troponin - the blood test that detects heart attacks
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- čas přidán 12. 07. 2024
- My name is Sanjay Gupta and I believe that high quality, jargon free health related information should be freely available to all. Please subscribe to @ yorkcardiology for more videos. My WhatsApp is 447951310008. Cardiac troponins are proteins that are found in heart muscle and play a role in the contraction of the heart muscle. If heart muscle is in someway damaged or injured, then cardiac troponins are leaked into the blood and can therefore be measured in the blood stream. They have therefore become exceptionally useful markers of cardiac cell injury and this is why anyone who presents to hospital with symptoms of chest discomfort will have a blood test to measure troponin to look for objective evidence of cardiac damage. The original troponin assays were not very sensitive and any detectable troponin in the blood was considered abnormal. As the assays for measuring troponins in the blood have improved, we now use high sensitivity troponin assays which are extremely sensitive at picking up Troponin into the blood and we are now realising that even healthy and normal people may have tiny amounts of troponin in their blood. However to find a troponin value which is above the 99% centile value is definitely abnormal as is a rapidly increasing troponin from baseline. The finding of a very high or rapidly rising troponin in a patient complaining of acute chest discomfort or a very abnormal ECG is all that is needed to confirm a diagnosis of a heart attack.
Here are 5 facts that you may find useful to know about Troponin:
I truly admire the way he explains this because it is clear and understandable. Thank you Dr. Gupta!
Thank you for advising us as patients to the reasons and relevance of troponin elevation and decline values. Your series of videos are a comfort and empowering to many who wish to manage their health by education as to risk versus benefit outcomes. It is as if you are a brother, uncle or father consulting with a family member as you teach.
Just found this channel, this cardiologist explains things so well and breaks it all down. He also managed to cover so much, without causing confusion. Just found an amazing cardiologist that teaches so well. Thank you consultant cardiologist Dr Sanjay Gupta! Would love to meet you one day! You sir are amazing
Thanks for sharing Dr. Gupta!!!
I had chest pain, pain down left arm, excessive sweating, fatigue, faintness back last year. They did my obs, ECG and normal blood tests. All came back fine. Luckily a doctor stopped me from leaving the Emergency Room. Sent for a troponin test and found I had heart damage and had suffered a heart attack. So lucky that doctor stopped me leaving. Was about to climb a mountain that morning too.
How are you feeling now?
I’m in the UK and I wish you were my Doctor, not many Doctors seem to care enough anymore and they don’t listen to patients, it’s sad that most people today, myself included get more help and information from people on CZcams who care enough to make these video’s 👏🏻👏🏻👏🏻
In my opinion there is no better cardiologist online.
I am from East Coast US and I wish we have more doctors like him who genuinely care about explaining medical facts and processes to patients, and even to the general public for their knowledge. Kudos to you Dr. Gupta!
As always great advise. Thank you so much for sharing your knowledge.
Thank you Dr! I had chest pain years ago, went to a clinic, great dr there did a triponon test me. Made me stay there till it came back negative. Thank you for telling us about this, ad women, we are often sent home saying its anxiety, and then die later! I will tell all my friends about this! Thank you! You never aswered me, do you play the piano?? Hugs from Florida, Debbie
Thank you so much for this video.
This is a such a wonderful lesson and gives important action items. Thank you Dr. Gupta. ❤
Thank you Dr very well said .
Regards from Australia ❤
Thank you very much Dr Gupta.
Thank you Dr.Gupta.
Thank you Dr….very well explained
I love all your videos. You are kind and clear and wonderful. Please can we have no music behind the video? It's distracting.
That was so informative, thx you
Great content, your a brillant doctor.
Excellent explanation Dr Gupta.
Thanks for this information given in simple terms 😊❤
Thank you. I first learnt about Troponin when in A&E resusc unit after SVT not resolved with the normal meds. After elevated T level, the registrar kept me in until a second later test showed T levels weren't rising and I was safe to be discharged.
I was admitted to hosp with chest pains in feb. Troponin very elevated so given angiogram. Turned out to be inflammation and diagnosed with myocarditis and high bp. An mri 6 months later luckily showed no damage. Was under extreme stress at the time of the chest pains too.
I had the same thing. Woke up with bad chest and jaw pain, felt awful. Drove to hospital, they did an ECG and thought it was a heart attack (I was only 29)! After a week in hospital and every test they had, it turned out to be myopericarditis. Happened again a year after, although much less scary as I knew what it was. Hasn't happened since thankfully, two years in the clear!
@@privatefeaces Im worried about a flare up again now that we're in all this Covid mess. We need to be very careful.
@@rebeccahayes1007 Yes we do, but like yourself I was overworked and very anxious when I had both of my flare ups. Don't worry too much! I've read many studies that Magnesium citrate is very good for the heart, it helps the muscle relax (and lowers overall anxiety)
@@privatefeaces good points. Keep well xx
privatefeaces j
Thank you.
Good morning dr gupta sir very vital information shared by you thanks 18/01/2020
another great educational video
I would love for you to do a diet for heart health. In detail that would be much appreciated. I love your videos and appreciate you taking the time to help!
Also, on whether nuts are good for heart health.
Do whole foods plant 🌱 base diet
Please, make a video on Angiotensin Receptor Blockers and Diuretics.. Their usage, side effects and their effects on kidney functions,,, thank you.... 😊
Thanks for the video
New sub ,great info and easy to understand ,just want to say I was in hospital december last year ,suspected heart attack my troponin was 582 docs got it down to 70 ,I was then given a angiogram via my wrist and showed my heart to be very healthy ,even though iv smoked for years (stopped now ) I was diagnosed with COPD but lung specialist didn't see it on my lungs ,I'm quite confused as I think I have the cardio stomach problem as I get breathless take panic attacks feel like I'm dying my daughter has phoned ambulance for me more than once as I honestly thought I was goin to die , could hardly breath ,I was 6stone until this month IV put on nearly a stone in weight taken 2years ,I'm 5ft 4inch was very thin ,now I get bloated tummy n feel breathless after eating I feel it's to do with my stomach ,also had left lung glued down 20years ago I haven't felt right since ,I'm glad I found your vids hopefully they will help me understand bit more ,thankyou
Do you mind me asking you if doctors have given you any anti inflammatory meds and/or pain medication?
The reason I asked is because I got myocarditis two days after Pfizer vaccine but it’s been three months now and even with medication I’m still dealing with symptoms. 😢
Thank you for the valuable information. So my AFIB attacks can elevate my Troponin, good to know.
Went into afib last week and my troponin was elevated.
Excellent information Dr. Maria T. Connecticut.
l had an event 2 yrs ago and my troponinh was elevated to I6 was that to elevated. M T. CT.
Great
Please consider refraining from the use of background music. I love your videos. They have brought me much peace but unfortunately, the background music does not. Thanks so much for all you do to help us learn.
You are awsome!
Dr. Gupta, I wonder if this is something you would like to cover one day, but I think it would be useful for many patients (like mine) who have panic attacks with or without any heart issues. Of course, we may have someone who has heart issues but don't panic about it because they know what their problem is, but others do and don't know what their palpitations or other symptoms are caused by. For those who don't have known heart issues, every new panic attack is a "potential heart issue that just may have happened" in their mind. Maybe you could explain differences from a cardiology standpoint as you are so good at being reassuring and also able to explain various conditions in clear and simple terms. Thank you.
I sort of had a 'panic attack' but is was vertigo triggered by heat as I was hot at the time.
Very interesting thank you. Could I ask if a heart attack has been confirmed by elevated troponin and ecg changes or confirmed in the “ cathlab “, why are patients routinely discharged from hospital with in about four days if they are considered a high risk of a big heart attack with in two weeks ?
Also if troponin is elevated and ecg changes are recorded why are some chest pain considered only to have been an episode of angina rather than a heart attack ?
Thank you
which troponin suggests MI exactly? C, I or T? And how do you rule out MI as opposed to Heart infection whilst noting elevated troponin levels? Is it mostly EKG?
Very clear and thorough. Thank you!
Thank you sir
Hello - I realize this video is a couple yrs old. You have been most informative. When you refer to "Elevated" can you expand upon a number? I have heard most patients experiencing a heart attack have readings in the thousands. Do you agree numbers lower than 100 should be of no concern? My readings taken a year apart are still around 56. *I don't know the correct form to show the measurements. Can you please give a rough idea of elevated?
Fascinating
Thank you so much for watching teresa. It'd mean a tonne to me if you'd consider subscribing to the channel - Sanjay (and bluebell).
@@YorkCardiology resprcted sir i am anxiety disorder patient and suffering from cardiophobia . i did manny ecgs an echo and ett test all are normal . but for satisfication i did trop i test today . lab ill get result tommorrow . respected sir my question is that troponin levels may raise falsely due to anxiety and pannic ?? Plz sir tell me i am too anxious regarding my heart health . i am too scared
CT coronary angiography is a easy 10 minutes test that is reliable and efficient in determining heart health prognosis. What do you think? Please advise. Thanks.
Great lecture Doctor. A question, what about people who have ablations? Would this procedure cause a rise in troponins? And if so, for how long.
My question too
Had high troponin...then 2stents and later a third.But throughout the whole event I had no pain,on!ly initial breathlessness.Three years on fine...BP and AF meds also blood thinner.
Lady aged 79
May I ask how long you have been taking both blood thinner and AFib meds?
@@gloriamaryhaywood2217 Yes.Nearly 3 years now. Lixiana and low doses of Bisoprolol/candesartan/amlopidine. Wish I could come off all of them!
I hear you. Wish I could come off my prescribed meds too! I take the blood thinner xeralto, and a low dose beta- blocker metoprolol. I am 65 years old. Had my first, and so far my only, afib episode last August.
I am also a cancer survivor so I guess that I should not complain!
Good luck to you, lady!😉
Thank you.Wishing you good health and happiness.💐💐
Blood thinners are only prescribed for 1 year after a stent?
Has Troponin test any role in post mortem?
It seems silly to conduct all autopsy cuttings if one suspect a person died of heart attack?
Also, in the case of aortic collapse, would Troponin level increase?
Thanks for your response.
I came in the hospital for toxic metabolic encephalopathy. Troponins were elevated the first test, but on the next test, when my condition was more under control it settled back down to normal levels. I had no chest pain, shortness of breath, difficulty breathing, etc. Only thing they did not do is a stress test because I couldn't have done it at this point anyway. They kept me in a bed and kind of made me weak.
Hello Dr, my Troponins were 24 then 22 on repeat above the threshold of 14 NHS UK, because I’d had a CT angiogram 5 weeks ago and a Clear Cardiac MRI they stated I’m likely fine - we had private consultations back in March and you were excellent I have POTs from long Covid I wonder if you could offer any advice? Am I ticking time bomb
Get right with Christ.
I had what I thought was a heart attack during the night. I felt ok when I woke the next morning but went to hospital for a check. My Troponin blood test showed an elevation 0.013 (cut point) rising to 0.043. I feel ok so have carried on as normal but having seen your video I'm worried now. I don't smoke, don't drink, blood pressure is normal, bloods normal, not overweight, healthy diet and lifestyle but a lot of stress.
I had very high troponin levels after 5th chemo. Then developed sepsis. But the high troponin was definitely the chemo.
Interesting that you didn’t mention this. Still kept me in cardiology for 3 weeks...
cardiotoxicity of cancer drugs, the side effects can be quite bothersome to put it lightly
Ugh. It's been 5 years since last chemo treatment,.. but I can certainly relate! Aggressive chemo nearly killed me. Yup, I also developed sepsis. Have Afib now which I'm sure being Poisoned by chemotherapy has something to do with it!!😞
Please answer urgent!!!!! Dr Sanjay Gupta you are the best I have been following you for long time. I am 25 wt is 190lb ht 6-1" and I think I started getting actual afib attacks on top of my 2 year old palpitations problem. I do have family history my dad has tychardia/ afib. But I havnt been diagnosed yet. I don't have any morbidities. My existing symptoms include chest tightness and contained pain under left breast area and feeling a bit breathless. My doc said they are anxiety related. However Then this new attack happened twice this month once out of blue when I was working on laptop at home and second at work I got up to give something to my boss and my heart suddenly started fluttering no pain but I felt like passing out and breathless however thank God both attacks lasted only few seconds (before this happened at work, I was having a feeling of some tightness and mild pain in left side or rather discomfort I have since last 2 years, I have days when I am perfectly fine but they don't last long and i return to this supposedly anxiety state. My heart rate is usually around 80 at work but I have Samsung watch so sometimes I am having this anxiety like symptoms and have 70). My concern is will it get worse, is stress a factor, is the heart beating fast and pain or tightness I often get while working also afib but the attack was worse afib? Is it fatal should I take meds? Please answer because I get more stress by these....i got stress tested about year ago and it was fine. Ekg and cardiology visit was about 8 months ago and it was normal. I am planning another visit soon but I are the most humble and informative doc I have ever seen so asking you. Thanks p.s: please answer in light of your afib types video because I have watched that in which you explained type 1 and 2 etc.
Thank you very much for all your wonderful informative videos. However I find the unnecessary background music EXTREMELY distracting and much prefer it quiet to be able to concentrate on your helpful words.
Hi Dr.
Heart damage or indications of a heart attack are shown at the EKG and echocardiogram?. Long after it happens?
I've always wondered that, because the time i was at the emergency room, no troponin test was made
Greetings from Bogotá, Colombia.
While we wait for Dr. Gupta's response, pathologic Q waves on an ECG mark the presence of current or past cardiomyocyte infarction. Patients may have Q waves and present no symptoms, much long after having a heart attack.
On Echo, you can look at a number of factors such as SV, concentric wall motion (akinesis, dyskinesis) and other parameters that indicated infarct to the myocardium
My mum has a stress heart attack and the ecg didn’t show any abnormalities only the blood test showed it
Why PVCs come with sourness in chest muscle if we feel that is not kinda heart related pain it feel like achy chest bone but often come with when PVCs increase....
🙌🙌🙌
CT coronary angiography is the best and easy screening test of health diseases according to Indian cardiologists in india (for example Saaol heart institute)
very important knowledge for anyone, thanks again
Love your videos. Wish there were not so many jump cuts. Seems it’s so overused now on CZcams.
My cardiologs in France can not give me an answer : why I had 1-2 min hart palpitation every night between 22.20 - 22.28. BP, Tripple bypass ,stents ,pace maker ,carotid. God knows what next.La vie est belle!Alive and kicking.
Can it show if you had a past prior heart attack or just a recent or active one?
Hi Dr. Sanjay! Thanks for all your tips! I'm from Birmingham!
Would you see elevated troponin levels with angina only?
Hello dr Gupta I am watching your programs as its greately involves me.QUESTION:Are you called like your father?Was he riding horses in 1970-80 in North London.I am 81 years old.Can be found on Internet.
hi Sanjay i got the Flu Jab 2 months ago in November 2019.
week and a half later i started waking up in the night with heart palpitations and shivering and trembling and numbness in legs feet arms hands
as i felt numb feet or legs i get up and start walking
it has been 9 weeks now
i find it hard to travel in the bus or car for and cant travel for more than 20 minutes i feel suffocated
i have been sleepless in 9 weeks some nights i get sleep i feel very weak in legs and arms
my arms and shoulders feel light
there were times when my legs or arms went “cool” cold
i stay at home now
im in UK the cold now a days when i go out i walk for 5 minutes and my head got numb and i felt i cant walk as i felt chest tightness and after completing the walk for 5 minutes i felt very uncomfortable shortness of breath and weak body suffocating feeling like will lose my breath
before flu jab i was fit and healthy with no medical history
i get flu jab every year with no problems
i get it because i was asthmatic as kid til teenage and had asthmatic attacks twice after each of my childrens’ births
all my tests ecgs, bloods are normal. no deficiencies
and i have never suffered from anxiety or depression. i am turning 42 next month.
please help me what is wrong with me. i want to feel normal please help me. i am having these suffocating sensation in the day
Did you find a solution to this problem?
Hey Doc what are the numbers for troponin. What is conceder high, low or normal?
My mother has trop I levels 200-fold high. Normal ECG, no obstruction observed in CAG. CMR shows mild myocarditis. The cause of myocarditis not clear. She has rheumatoid arthritis and has been ON HCQ for long time. What could explain such high Trop I levels, if no major problem from CAG and CMR? Thank you
Doctor could you make a video explaining what is a SILENT HEART ATTACK.
I’m so worried because I have some of the symptoms, but someone told me my symptoms are for anxiety and not a heart attack only because my stress test and echo in 2018 came clear. I have PVC’s and a mild MVP and in 2019 I had a CTA Coronary and it came clear too
Yeah anxiety mimics ALOT of symptoms unfortunately. Look up Trey Jones and Vacate fear on CZcams they'll explain it
I had elevated heart enzymes 3 years ago, including Troponin. I had angiogram, perfectly clear. It was determined that my elevated levels were from EXTREME stress and severe anxiety. Is that something you've seen? I was only 31.
Great question
I'd like to know as well.
I experienced exactly the same symptoms, elevation of troponin I especially high sensitivity troponin can not be interpreted alone to make a definitive diagnosis of an infarction. I too was given an invasive catheter, and turned out to be clear, only based on an elevated troponin I result
Were you diagnosed with Takotsubo?
@@belle1761 no, they said it was just stress. No heart attack.
@@Sarah_Elizabeth_Mitchell I asked because I had what they thought was a heart attack 3 years ago. My Treponin was elevated. They did a cardiac cath but no v
Blockage. The Echo revealed the "balooning" typical of Takotsubo cardiomyoparhy. It was stress induced. Turns out that this condition mimics a heart attack
Is troponin level 2.5 is serious or not for a 47 yr old woman? It will be leads to heart attack?
Dr. Saab I have chest pain 5 days ago
Can I test troopolin I test
Is it realable after 5 days of chest pain
What does low level(way below the normal range) of Troponin signify?
I think its ok, no risk of heart problem, I am HCA, not a doctor
Hey Doc Gupta: A Troponin reading of 1.33 after 6hrs of the attack, 25.44 reading after 30 hrs, and 7.33 reading after 60hrs. These are the readings of one patient. Is that possible?
Do you play that piano? You must have excellent kundali.
I am a 70 year old male. In October 2021 I was admitted to hospital with a fever and was diagnosed as having Pneumonia. I did make a recovery but was surprised to be told that I had elevated levels of Troponin in the blood. I also have a "machinery murmur". I may have had a "Silent Heart Attack". I would be interested to know if you have any comment or advice.
Dr Sanjay I'm currently in the hospital had chest infection inflammation echogram show all good with heart but from 2 days tropnin has increased from 3000 to 6000 doctor only prescribed ibuprofen anti inflammatory to reduce the inflammation hoping to reduce tropin eventually...
Please give me some advise should i be worried?? 37 year old male vegetarian no alcohol or smoke
What about a Troponin level of
The calcification scan (CAC) can actually see the level of calcification in the coronary arteries. This can give you a clear risk score for developing heart disease
I did a ct score scan and it came out zero. I had a cardiac and pulmonary scan and they said everything look good but I still get chest flutters smh
@@MsLadyBluesWorld atrial fibrillation perhaps
But not soft plaques
@@shiningglory5414 RIGHT! CAC detects only hard plaque which is NOT the culprit.. SOFT one is dangerous!
@@jerseytony1soft plaques perhaps can be conquered by nattonkinase vitamin k2
Would Takotsubo cause high Troponin levels?
Why my troponina is always higher than the limit? I always land for 24 hr observation because of that.
Would you talk about the high-sensitivity troponin interpretation?
No diagnosis yet, as not seen cardiologist yet. Mi traponin has risen twice. First time mi have symptoms checked, had angiogram that came back normal. Second time, happen un having another angiogram in a few dias. Does no look a good, mi feel so weak.
Doctor I'm from Malaysia my troponin i 1.30 second day check my troponin t 250 and my creatinine kinase level 462 now I'm taking medication. Sir how to reduce my troponin and creatinine kinase
My high sensitivity troponin test is always marginally higher than normal range. Normal being less than 14, and my ranges between 15-19. Not significantly high, but it concerns me that some months in rises and some months it decreases. Been testing regularly for the past 9 months 🙄
My troponin is
Hello, wondering What is the purpose of Troponin labs Q6H in ICU? Diabetic patient, 25-30 percent ejection fraction, nitro prn. (New nurse here)
My home care patient is 18 months post double bypass, passed out on me & I thought he had another heart attack. Troponin level was 289 at the ER around 4pm then came down to .2 later that night and was .13 today. Doctor thinks he has a blood infection, not heart attack. Is the heart infected perhaps?
How is he
U look dashing
Is a Troponin level of 25 high? I was sent home from hospital and then suffered a cardiac arrest. Should they have kept me in please?
My troponin t is always 3 in range of 0-14ng/l. But I still have chest and nausea and vomiting from time to time and haven’t been diagnosed with nothing. Is that normal? Some say is caused by anxiety and panic attacks
I am in a horrible situation with my arrythmia stuck in spain... I really need some advice about troponin. Is there any way I could please ask you? I am having suspected Pots and svt but have to wait months for a holter. Each time I have been to emergency in the last two days the troponin has gone up from 3.8 to 7.4 but because the normal level for them is 14 in this lab they just say it is negative but don't explain why 1)there is any triponin at all and 2) why are they going up? I am so so scared that each time the svt happens it seems to increase even though still normal. Up until now every ech in hospital is normal. Please if you can offer advice I would be so grateful. I am absolutely terrified.
Like this doctor never reply understand
Does this still happen to you?
Mine was '6'. just one over the safety limit. A 2nd test and hour later was the same/ What does that mean? six what?
My troponin I is
same thing happened to me! i got 0.50 and was discharged as normal didn't even explain my ekg...
Is it normal 0.50 ?
*You not The Dr from CNN?*
What is High Troponin rise 50,90,120 ?
😎
I am a 40 year old male my troponin levels have been elevated for a few months I can hardly breathe I had a pneumothorax about a month ago I’ve been to hospital several times and they can’t figure it out I’ve also been itching on my side where the chest tube was for over a month this has effected my life and ability to do anything if anyone can help please please please do so we really need it thank you
Like this doctor never reply please understand
I have just learned that serious burns cause troponin levels to rise. Apparently, burns (even to the extremities) cause heart issues. How and why do burns are capable of marked cardiac issues? I am a burn victim. I am trying to learn is the burns are the beginning of my heart problems.
What does a troponin level of 79% indicate?
Troponin I 0.990 ng/ml means???? Please Please pleaseeee replyy Sir😔😔😔😔
Crap :(, i left against the advice of cardiologist , however he perscribed me the daily asprin and rosuvastatin 40 40 mg and said he would be informing my doctor and getting me setup for a ultrasound on my heart and to be hooked up to machine while on tredmill...the scary part was that if those tests show anything he said id have to get something up my arm and dye into my heart for further testing :(, part of me wanted to stay but agh... i hope im ok
could troponin detect angina
Good question!!
I had a blood test to check if I'd had a heart attack when I went in with chest pain etc and it was fine.
I've had an echocardiogram which was normal.
I get flutters in my chest , and at the same time feel a strange sensation in my throat like I've missed a breath but I havnt.
Theyve come on gradually over 2 years and now can happen numerous times a day. I get chest pain and pain in my neck and left shoulder, not every time but sometimes (when they feel more prominent or have one straight after another) they come on and go away suddenly, and last a few seconds a time.
What would you say it is?
I dont have caffeine or alcohol etc so that's not causing it. I'm starting to get worried. What would you suggest please?
I'm a health coach with several years experience in functional medicine and it sounds like you are having PVCs. They are usually brought on by anxiety and/or eating certain foods. If it happens more after eating then more than likely that is the problem, especially after eating sugars or anything that contains sugars. The fix is whenever you feel the discomfort to make yourself burp repeatedly until you let all the air out of your stomach. This fixes the problem most of the time and it's caused by an irritated vagus nerve due to excessive gas. You can also take magnesium glycinate because if you are deficient it also contributes to heart palpitations. You can rule out most heart issues by simply walking up 2-3 flights of stairs. If you can accomplish this without being extremely out of breath and/or without ANY chest discomfort then you are most likely fine. Of course it's not guaranteed, but from my experience someone with heart issues experience extreme breathlessness when doing any type of physical activity.
Thankyou for your reply! , il deffinately look into this. Are PVCs harmless If theres no other major symptoms? I could speak to my doctor about it and see about taking the supplements you suggested. I'm generally vitamin deficient so it makes sense! Thanks again
How are you doing now? Are the symptoms still around?
@@raeylei3926 hey, yeah still there, with lockdown etc theres no chance of even speaking to a doctor. I saw a cardiologist before hand and he barely spoke any english and tried to fob me off 🤷♀️ so I wasted so much time just waiting for that appointment 🙈 thanks for checking in!