elevated heart enzymes

[tammybiga]

My husband went to the hospital this weekend for chest pain, shortness of breath and dizziness. EKG came back fine so they took some blood. They then told us that his blood test results said his heart enzyme level was 1.9 and he probably has a mild heart attack and there was some damage to his heart. They told us they were putting him in the ICU and hooked him up to a couple iv's with medications. Three hours later they re did the blood test and this time it came back 0.06. They stopped the iv's and all medications and told us that he did not have a heart attack and there was no heart damage. He is 38 years old, a smoker, and never had heart or blood pressure problems in the past. Why would his heart enzyme level be so high and than 3 hours later it is fine? We are very concerned.

[erijon]

That actually makes sense. It is common for an elevated heart rate to cause some minor, temporary damage to the heart muscle which would increase the troponin levels temporarily so it is very possible that the tachycardia was the cause. It could have been triggered by stress, panic attack or some external factor like caffeine.

In any case, I would follow up with a cardiologist.

Wishing you the best,

Jon

[tammybiga]

I also should have mentioned that he felt like his heart was beating super fast and really hard. He said it felt like his heart was going to beat right out of his chest. Today, he feels like the left side of his chest is bruised.

[tammybiga]

No, the ER said they could not explain it. Just told us to follow up with a cardiologist. The cardiologists in my area (Myrtle Beach) all say 2 to 3 month wait and we don't have a PCP here. We are moving back to Connecticut and I am thinking about calling our old PCP from there and asking if they can help get him into a Dr. there.

[itdood]

That's not uncommon with marginal levels.  

He should still get a full workup by a cardiologist.  don't treat the ER visit as a diagnostic session.  far from it, they are there to deal with emergencies and decided he was not.

Smoking is the worst risk factor for CAD in my humble opinion.  Start with his PCP and some blood work, lipids, enzymes and maybe his PCP can get him into a cardiologist sooner.

[erijon]

The amount of cardiac troponin in the blood initially rises in about 4 to 6 hours. Peak concentrations appear at 18 to 24 hours after symptoms of a cardiac event begin. My guess is that because your husband's numbers dropped so dramatically in 3 hours they determined the elevated troponin levels were not due to a cardiac event.

Many diseases, such as sepsis, hypovolemia, atrial fibrillation, congestive heart failure, pulmonary embolism, myocarditis, myocardial contusion, and renal failure, can be associated with an increase in troponin level as well. Did they give you any thoughts on why they felt his troponin was elevated?

Jon