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Troponin Test — Blood Test For Heart Attack
Updated on November 12, 2022
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Troponin Test — Blood Test For Heart Attack

The troponin test or a cardiac troponin (cTn) assay measures the amount of troponin in the blood. Troponin is a protein found in the heart muscle.

Normally, troponin levels are so low they are undetectable. But small amounts will be released into your bloodstream when the heart is damaged.1

Doctors often test troponin levels to determine if you recently had a heart attack or are at risk. It’s also used to check for other forms of heart damage.

For this article, we asked our resident medical reviewer Dr. Rizza Mira about everything there is to know on the troponin test.

Quick Facts on Troponin Testing

  • Helps doctors diagnose a heart attack
  • Can be used to monitor a patient who has had a heart attack
  • May be combined with other tests, including an ECG and chest X-ray

Why Take A Troponin Test?

Doctors usually order a troponin test to see if you suffered a heart attack. It’s also used to assess patients who want to undergo surgery but have a high risk for heart damage.  

According to Dr. Mira, troponin levels start increasing three hours after a suspected heart attack. Its levels peak at 24 hours.

Troponin testing can rule out a possible heart attack in patients with unstable angina. It’s a condition that causes chest pains because the heart isn’t receiving enough blood. 

What Does A Troponin Test Check For?

The troponin test measures the levels of two types of troponin in the blood: troponin T and I. These troponins are found mainly in the heart muscle.1

“Another type of troponin, troponin C is not specific to the heart muscle. So it’s included by most doctors,” explains Dr. Mira.

Troponins help the muscle tissue in the heart contract. They maintain your heartbeat and pump blood through your body. They are only released when the heart is damaged or injured. 

A troponin test may look for troponin T or troponin I. It depends on the lab performing the test. 

When Should You Take A Troponin Test?

Your doctor will order a troponin test if you have recently experienced heart attack symptoms. These symptoms may include: 

  • Shortness of breath
  • Chest pain or discomfort
  • Feeling pressure in your chest 
  • Feeling lightheaded, faint, or weak   
  • Pain in the neck, jaw, back, shoulder, and arm 
  • Nausea or vomiting
  • Sudden fatigue
  • Anxiety
  • A sense of impending doom

Troponin levels usually become elevated within 4 to 6 hours after symptoms appear.1

Your doctor may also order the test if you’re at risk of suffering heart damage from surgery. They might ask you to take the test before and after heart surgery to check for damage.

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How Much Does A Troponin Test Cost?

A troponin test is usually administered in a hospital or emergency room, which means most health insurance companies cover the cost. Without insurance, expect to pay $11 to $100.

You should ask your insurance provider if a troponin test is covered under your policy.

How Troponin Testing Works

The troponin test is usually performed at a hospital or emergency room. Since it’s used to test for a heart attack, a quick diagnosis is needed to save a person’s life.

Before Your Test

You don’t need to do anything to prepare for the test.

Collecting Your Blood Sample

To perform the test, a phlebotomist or other trained healthcare professional will draw a blood sample from a vein in your arm. 

They will apply a band to the upper arm to increase blood supply to the vein. Next, they will clean the puncture site with an alcohol pad, insert the needle, and begin drawing blood. 

You may feel a slight sting or pinch when the needle is inserted or removed. The entire process normally takes less than a few minutes. 

After You Take The Test

After collecting your blood sample, the phlebotomist will apply a bandage to stop the bleeding. You should get your test results within one to two hours. 

The test is usually repeated at least twice within 24 hours after the first test. It’s so doctors can keep track of changes in your troponin levels.  

Interpreting Troponin Test Results

When your doctor receives your test results, they'll check to see if your levels are outside the reference range or the range of values normally found in a healthy person. 

This range will vary slightly according to the type of test performed and where you receive the test. Men and women may also have slightly different reference ranges.

“Troponin levels are often combined with an electrocardiogram of the heart to rule out a heart attack,” says Dr. Mira.

If your troponin levels are normal within 12 hours after showing symptoms, it’s very unlikely that you had a heart attack. High levels during this time may mean you suffered a heart attack.2

The higher your troponin levels, the more likely you will suffer a heart attack. Troponin levels can remain elevated for up to two weeks after a heart attack.1

Other causes of high troponin levels include:3

  • Viral myocarditis, heart inflammation due to a viral infection
  • Chronic kidney disease
  • Unstable angina
  • Congestive heart failure
  • A blood clot in the lungs
  • Heart surgery
  • Cardioversion (the use of an electric current to restore a normal heart rhythm)
  • Severe COVID-19 infection

How Accurate Is A Troponin Test?

The troponin test is the gold standard for diagnosing heart attacks and other forms of heart damage.4 However, it can still lead to false negatives and false positives.1

False Negative Troponin Results  

A false negative occurs when troponin levels do not increase following a heart attack, even though they’re high. False negatives results may appear if:5

  • The test is performed too soon — it usually takes a few hours for troponin levels to increase after a heart attack. You may need to wait a little longer and repeat the test.
  • Biotin supplements — Biotin is a B vitamin that can cause troponin levels to appear to be inaccurately low. Make sure to tell your doctor if you’re taking B vitamins.

What Happens After A Troponin Test?

If the doctor suspects you’ve had a heart attack, they will recheck your troponin levels over 24 hours. This is to see how your levels change over time.

Your doctor may also order more tests to confirm a diagnosis, such as: 

  • Electrocardiogram (ECG)
  • Complete blood count (CBC)
  • Chest and lung X-rays
  • Heart ultrasound (echocardiogram)
  • Creatinine testing
  • Blood urea nitrogen (BUN) testing
  • Glucose (blood sugar) tests
  • Electrolyte panel

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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. Cardiac troponins: from myocardial infarction to chronic disease” Cardiovascular Research
  5. 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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