It takes about 30 minutes for the troponins to go up during the time of the heart attack, so these labs aren't used for diagnosing heart attacks, instead they are used to confirm it. At the time of the heart attack the most important findings are the ECG findings and the patient's symptoms. Those decided whether a large enough territory of the myocardium is at stake and whether a patient needs to be taken for an emergent intervention vs urgent intervention. Tropnonins may never be checked at the time of the heart attack, and even if checked within 30 minutes of symptom onset they may be normal (as stated above). That does not mean that a heart attack isn't ongoing, it just means that it's early on during its course and not enough enzymes have leaked into the blood stream. Once the heart attack has been going on for about 4 hours, these enzymes are elevated significantly in the blood, but they don't peak until about 24 to 48 hours post heart attack. The rise in troponins isn't uniform amongst different patient so there is no standard as to a typical rise during an MI. Any elevation in these enzymes is however considered a sign of a recent heart attack.
many thanks for ypur reply and explanaition......appreciate it ...
Regards