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High Troponin Levels — What They Mean For Your Heart Health
Updated on October 14, 2022
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High Troponin Levels — What They Mean For Your Heart Health

Troponin is a protein involved in muscle contractions. In healthy individuals, troponin levels in the blood are so low they are undetectable by most tests. 

When the heart is damaged, it releases troponins into the bloodstream. High troponin levels are often seen in heart attack patients. However, other conditions can cause high levels.

We asked the help of general practitioner Dr. Rizza Mira to help us explain what high troponin levels mean and what you can do about it.

“Myocardial infarction is the most common cause of high levels of troponin. A troponin test is the best diagnostic tool used by health professionals,” she says.

What Is Troponin?

Troponin is a protein complex that helps muscles contract. It’s found in skeletal muscle and heart muscle. It helps maintain a healthy heartbeat so it can pump blood through the body.1

There are three types of troponins:

  • Troponin C initiates muscle contraction by binding to calcium.
  • Troponin I prevents muscles from contracting in the absence of calcium. 
  • Troponin T  — facilitates muscle contractions by binding all three troponins to another muscle protein called tropomyosin. 

Together, these three subunits form the troponin complex

The troponin T and I found in the heart differ from those found in skeletal muscles. The troponin C found in cardiac and skeletal muscle is the exact same type.1

When damaged, heart tissue releases troponin T and troponin I into the bloodstream. This is why troponin tests only measure these two.

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What Are Normal Troponin Levels?

Troponin levels are typically undetectable in most blood tests. It’s considered “normal” when they fall within the reference range.2

Even the slightest increase may be a sign of heart damage. Very high troponin levels mean it’s likely the heart has been damaged. 

The reference range will vary slightly depending on the lab and the type of troponin being tested. With that said, the most common normal range for troponin testing is:2

  • Troponin I 0 to 0.04 ng/mL
  • Troponin T 0 to 0.01 ng/mL

Some labs may also have slightly different ranges for men and women. 

What Is Considered A High Troponin Level?

Troponin levels are high when they’re outside the normal range, such as above 0.04 ng/mL for troponin I and above 0.01 ng/mL for troponin T.2

These are signs that damage to the heart has occurred. 

Troponin I levels above 0.4 ng/mL suggest that the person may be at risk or has already suffered a heart attack. It requires immediate medical attention.

What Causes High Troponin Levels?

High troponin levels may be a sign that suffered a heart attack. According to Dr. Mira, blood clots are the most common cause of heart attacks. Higher levels suggest more serious damage.

If your troponin is high, your doctor will retest your levels to see how they change over time.

Troponin levels will rise 4 to 6 hours after a heart attack. This peaks around 12 to 48 hours after, but they can stay elevated up to two weeks later.2

These health conditions may also cause high troponin:3

  • Viral myocarditis (heart inflammation due to a viral infection)
  • Chronic kidney disease
  • Unstable angina (lack of blood flow to the heart that causes chest pain) 
  • Congestive heart failure
  • Blood clot in the lungs (pulmonary embolism) 
  • Cardioversion (the use of an electric current to restore a normal heart rhythm)
  • Severe COVID-19 infection
  • Sarcoidosis (an inflammatory disease that affects the heart)
  • Heart trauma, caused by a sudden blunt impact to the chest or heart surgery

Heterophile antibodies can cause false positive results. These are antibodies released during autoimmune diseases, blood transfusions, vaccines, and certain foods.4

Treatment for High Troponin Levels

Treatment depends on the disease causing your levels to be higher than usual. Additional diagnostic tools are used to diagnose and find out the exact location of heart damage. 

If you’ve had a heart attack, the doctor may suggest treatments to restore blood flow and prevent further heart damage. These include: 

  • Thrombolytics — dissolve blood clots that block blood flow to the heart.
  • Anticoagulants — thins the blood and make it less likely to form clots. Examples include warfarin and heparin.
  • Antiplatelets — prevents platelets from sticking together and eventually forming clots. Aspirin is the most commonly used.
  • Nitroglycerin — expands blood vessels to increase blood flow to the heart and relieve chest pain.
  • Beta-blockers — slows heart rate and reduces high blood pressure to protect the heart from further damage.
  • ACE inhibitors — reduces high blood pressure by widening blood vessels.

“ACE inhibitors like captopril and enalapril also prevent the heart from changing its structure due to damage,” explains Dr. Mira.

In severe blockages, blood flow to the heart can be restored with a cardiac stent (a tube that keeps arteries open) or a coronary artery bypass surgery.

The doctor may also prescribe statins to reduce your risk for future heart attacks and complications. But if your high troponin level is caused by reasons other than a heart attack, your doctor may suggest other treatments.

Why Test for Troponin?

Troponin testing checks for damage to the heart. Doctors usually order a troponin test when a patient shows symptoms of a heart attack. 

Heart attack symptoms include:

  • Chest pain or discomfort
  • Shortness of breath 
  • Pain in the arms, legs, jaw, or neck
  • Sudden fatigue
  • Feeling lightheaded, faint, or weak
  • Nausea or vomiting 

Troponin testing is also recommended for people who want to undergo heart surgery but have a high risk of cardiac injury.

A doctor will consider all your symptoms and health history to diagnose your condition. They may also need more tests like a chest X-ray, an electrocardiogram (ECG), and blood tests.

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Resources

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  1. Troponin” StatPearls 
  2. Troponin Test” Clevelandclinic.org
  3. The meaning of elevated troponin I levels: not always acute coronary syndromes” The American Journal of Emergency Medicine.
  4. What to do when you question cardiac troponin values” European Heart Journal: Acute Cardiovascular Care.
Dr. Rizza Mira
Dr. Rizza Mira
Medical Reviewer
Dr. Rizza Mira is a medical doctor and a general practitioner who specializes in pediatrics, nutrition, dietetics, and public health.

As a pediatrician, she is dedicated to the general health and well-being of children and expecting parents. She believes that good nutrition, a healthy lifestyle, and prevention of illness are key to ensuring the health of children and their families.

When she’s not in the hospital, Rizza advocates and mobilizes causes like breastfeeding, vaccination drives, and initiatives to prevent illness in the community.
Will Hunter
Will Hunter
Content Contributor
Will is a content writer for KnowYourDNA. He received his B.A. in Psychology from the University of California, Los Angeles. Will has 7 years of experience writing health-related content, with an emphasis on nutrition, alternative medicine, and longevity.
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