Troponin

Troponin test

Troponin test measures the level of troponin in your blood. Troponin is a type of protein found in the muscles of your heart. Troponin isn’t normally found in the blood. When heart muscles become damaged, troponin is sent into the bloodstream. As heart damage increases, greater amounts of troponin are released in the blood.

High levels of troponin in the blood may mean you are having or recently had a heart attack. A heart attack happens when blood flow to the heart gets blocked. This blockage can be deadly. But quick diagnosis and treatment can save your life.

Other names: cardiac troponin I (cTnI), cardiac troponin T (cTnT), cardiac troponin (cTN), cardiac-specific troponin I and troponin T

Troponin Test Details

To understand what is Troponin test, you must first know what Troponin in blood means; what is Troponin I and Troponin T.

Troponin is a group of three proteins:

• Troponin C

• Troponin T

• Troponin I

Now, exactly what is Troponin I and T as cardiac makers? Only Troponin I and Troponin T regulate heart muscle and tissue contraction, not Troponin C.

Now, back to what is Troponin test? A Troponin test can measure the levels of Troponin in blood. These proteins are released after damage to the heart muscles. The greater the damage to the heart, the higher the Troponin levels in the blood.

Troponin levels may be rise approximately 4 or 6 hours after heart damage. Troponin in blood continues to remain raised up to 2 weeks thus providing a greater time range to detect the problem. In angina patients, raised Troponin levels means aggravation in the condition and high risk of heart failure.

However, Troponin test should not be the only investigation to diagnose a heart problem. It should be combined with physical examination, medical information, ECG, etc.

Purpose of Test 

Troponin is a type of protein found in heart muscle but not typically found in the blood. However, when the heart is damaged, this protein is released into the bloodstream. Even a slight increase in troponin level can signal some damage to the heart. Very high levels of troponin indicate that a heart attack has occurred.2

You might have a troponin test if you have signs of a heart attack or severe heart failure. Sometimes, there are warnings (e.g., fatigue, chest tightness) in the months before a heart attack, but one can occur without any warning. A heart attack generally begins suddenly and worsens rapidly.

Indications for a troponin test include:

  • Pain, pressure, tightness, or discomfort in the chest
  • Arm, shoulder, neck, back, upper abdomen, or jaw pain
  • Shortness of breath
  • Weakness or fatigue
  • Nausea, vomiting
  • Pale or blue skin or lips
  • Sweating
  • Heart palpitations (a sense that your heart is beating rapidly)
  • Rapid breathing
  • Confusion, dizziness, or loss of consciousness

A silent heart attack is a heart attack without the typical symptoms. It can be characterized by a cold sweat, dizziness, and generalized weakness. If your healthcare provider is concerned that you could be having a silent heart attack, you might have a troponin test.

What is it used for?

Troponin

This test is most often used to diagnose a heart attack. It is sometimes used to monitor angina, a condition that limits blood flow to the heart and causes chest pain. Angina sometimes leads to a heart attack.

This test may also be used after you were diagnosed with a heart attack and admitted to a hospital. Testing is usually repeated two or more times in a 24-hour period. This is done to see if there are any changes in troponin levels over time.

Why do I need a troponin test?

You may need this test if you have been admitted to the emergency room with symptoms of a heart attack. These symptoms include:

  • Chest pain or discomfort
  • Pain in other parts of the body, including your arm, back, jaw, or neck
  • Trouble breathing
  • Nausea and vomiting
  • Fatigue
  • Dizziness
  • Sweating

If you have symptoms of a heart attack, call 911 immediately.

What happens during a troponin test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Risks and Contraindications

A heart attack is a medical emergency, but a troponin test does not cause any adverse effects. The results should be interpreted in the context of your medical history, symptoms, and other tests.

You will likely have this test at the same time as other tests that are used to assess the likelihood of a heart attack. You don’t need to do anything to prepare for it.

Timing 

A troponin level is obtained using a standard blood sample, drawn from a vein. The procedure takes a few minutes.

Location 

You might have your troponin test done in the emergency room if you go there complaining of symptoms that are consistent with a heart attack or severe heart failure. Similarly, if you show signs of a heart emergency when you are in your healthcare provider’s office or while you are an inpatient in the hospital, you may have a troponin test. n some circumstances, such as if you are having a follow-up troponin test, you may have the test as an outpatient in a blood-testing center.4

Food and Drink 

You don’t need to make any special dietary adjustments for this test, as food and drink do not affect the result.

During the Test

A nurse or a phlebotomist will perform your blood troponin test. If you are also being evaluated for an emergency heart condition, your healthcare provider will likely be nearby or in the room checking your heart sounds, pulse, and other diagnostic heart tests.

Pre-Test

Along with your test, you are likely to have other tests that can help your healthcare providers know if you are having a heart attack. You will probably have an EKG . This is a non-invasive test in which electrodes are placed on your chest to detect the electrical activity (and any abnormal changes) produced by your heart as it beats.

You will also have your blood oxygen level measured with a non-invasive pulse oximeter. This is a small device which is placed on your finger.

You might also have your blood oxygen, carbon dioxide, and pH measured with an arterial blood gas (ABG).1 An ABG test requires an arterial blood sample, and does not use the blood sampled for your troponin test, which is collected from a vein.

Throughout the Test 

If you are in the emergency room or your healthcare provider’s office, you will have a band wrapped around your arm, just a few inches above the vein that will be punctured for your troponin test. The skin will be cleaned, and a needle will be placed to collect the blood sample. After a few minutes, the band and the needle will be removed.

Alternatively, the blood might be taken from another vein, such as a vein in your hand.

Sometimes, if you are in the emergency room or staying as an inpatient in the hospital, a intravenous (IV, in a vein) line will be placed in one of your veins so that blood can be collected as necessary. This prevents the need for repeated punctures.

The blood sample for your troponin test might be collected using your IV if you already have one in place.

Post-Test

If you have a needle puncture for your troponin test, you will have a bandage placed over the puncture site and your nurse will check on you periodically to make sure that it has stopped bleeding.

Procedure

Troponin I test procedure is a quick, simple test using a few milliliters of blood from the patient’s vein. The test timing must be minimum 6 to 12 hours after the start of cardiac symptoms. No prior test preparation is required. The procedure takes around 10 minutes only using a rapid test kit. A blood sample is drawn by a needle from a vein in your hand/finger.

Troponin I card test is the most reliable Troponin I test. According to a study: “The Troponin I Test Device (Whole Blood/Serum/Plasma) has been compared with a leading commercial cTnI EIA test, demonstrating an overall accuracy of 98.5%.” (Ref: www.ekoweb.fi/images/pdf/Cardiac_Troponin_I.pdf)

Troponin I test procedure is a qualitative test to detect raised Troponin I levels in whole blood/serum/plasma. The blood sample can be drawn either by fingerstick or venipuncture method. The blood sample is added to a handy test device using various other aids like droppers, capillary tubes, etc. This device is like a quick reader with markers as indicators.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

Test Report

Troponin

A normal range of Troponin I test is below 0.04 ng/mL. Troponin concentration over Troponin normal range that is at 0.40 ng/mL and higher, could be an indicator of a heart injury: Please consult a doctor. Troponin concentrations of 0.04-0.39 ng/mL may require a series of Troponin test. Over 0.40 ng/mL is well outside the Troponin normal range and needs immediate doctor consultation.

What do the results mean?

If your results show normal troponin levels for 12 hours after chest pain has started, it’s unlikely that your symptoms were caused by a heart attack.

If even a small level of troponin is found in your blood, it may mean there is some damage to your heart. If high levels of troponin are found in one or more tests over time, it probably means you had a heart attack. Other reasons for higher than normal troponin levels include:

  • Congestive heart failure
  • Kidney disease
  • Blood clot in your lungs

If you have questions about your results, talk to your health care provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a troponin test?

New studies show that a new type of troponin blood test may be able to identify people who are at greater risk for heart attacks before they even have symptoms. The test is able to detect very small amounts of troponin.

Show references:

The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

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