Please Help With Heart Concern

[OneSunnyDay]

I'm a first timer here and would appreciate any assistance. I'm a 35 year old male, weighing 250lbs and 5'11 in height. I don't smoke, drink or use street drugs. A little history: I was hospitalized in 2012. I felt chest vibrations and was taken to the hospital. My troponin level was elevated and all other tests (ekg, x-rays, stress-echo, coronary angio) were negative. I was then hospitalized 4 weeks ago with chest pressure. My troponin was elevated again. I believe both times my troponin elevated to .159. In any case, four weeks ago they performed x-rays, ekg, and echocardiogram, all results were normal. I saw my primary physician two days later and my troponin level came back as normal. I just had a stress test performed last Wednesday and the cardiologist gave me results that concerned me. He then said that the hospital didn't perform the echo correctly. I was like......ok...... Before I post the results, is there any sickness that can cause an increase in measurements within a four week span? Could the cardiologist machine have been incorrect? I'm at a loss about what to think. I talk to my doctor today and she didn't know why the results from four weeks ago differ from today. She submitted for an echocardiogram today.

Test Results:
Clinical and Hemodynamic Findings: Baseline HR of 66 bpm increased to to 166 bpm after 6 minutes 30 seconds. This corresponds with 89% of MPHR. Baseline BP of 117/78 increased to 160/80. No chest pain. Exercise was discontinued because of fatigue and dyspnea.

Electrocardiograph Finding: Baseline ELG showed normal sinus rhythm with RSR prime patterns in leads V1 and V2. No ischemic changes or dysrthymia was seen.

Echocardiographic Findings: Baseline echo showed moderate LA dilation of 4.6 cm, normal LV size of 4.2 cm, mild LVH, normal wall motion and EF of 60%. Diastolic function and RV motion is normal. Valves have normal appearance with mild MR and TR and estimated RV pressure of 35mmHg. Post stress images demonstrate normal response.

Discussion: (1) Exam negative for ischemia (2) Fair exercise capacity (3) Moderate LA dilation with mild LVH. Normal LV size and EF of 65% (4) Normal appearance of valves with mild MR and TR and estimated RV pressure of 35mmHg.

[Terrilentini]

I am interested to know how you are doing. I had a similar experience except my stress test was normal as was everything else. I am wondering if there is anything else that can contribute to a mild rise in Troponin.. In a 4 day hospital stay the numbers fluctuated as follows .23 .33 .26 .44 ER doc and follow up with cardiologists comes up with no answer. I did have a stressful even prior.

[Paderla Anitha, DNB]

Hi, mild variations in findings can occur from center to center and also may vary with the technician. From the report there is evidence of mild MR and TR and estimated RV pressure of 35 mmHg and mild LVH. RVSP is used to estimate right side pressures in the vessels leading to the lungs. This is used to determine pulmonary hypertension. A normal value is less than 35 mmHg. Also, LVH can occur with hypertension. These findings are correlated clinically. Please discuss this with your doctor am sure he will provide further assistance. Regards.