High Sensitivity Troponin

Troponin is a cardiac protein which is released into the blood when heart muscle has been damaged. It takes 10-12 hours for troponin to rise after a cardiac event. Therefore, 2 tests need to be done 10-12 hours apart to see if there is a change in troponin levels. If there is a significant rise, the patient can be diagnosed as having a cardiac event rather than their symptoms being due to a non-cardiac cause.

The patient will have to stay in hospital while these tests are done.

Also, regular troponin levels can be raised by other conditions such as:

High sensitivity troponin is able to pick up lower levels of troponin in blood and see changes in troponin levels sooner. Is also a very good negative indicator - if high sensitivity troponin isn't raised, you know the patient isn't having a cardiac event, whereas if it is raised, 1:200 will have actually had an MI. Therefore, this still is not a very accurate test. So if the patient has ongoing chest pain or your clinical suspicion of MI is high, but their troponin isn't raised, don't rule out MI as a diagnosis.

This decreases the patients stay in hospital as if there is no change patient can go home.

Not available at Rural General Hospitals, is available at Raigmore.

Can you think of an alternative diagnosis in a patient who has chest pain but no rise in troponin?