Heart attacks are serious medical emergencies that require immediate attention. Timely diagnosis is crucial to ensure prompt treatment and minimise potential damage. While in most cases a person suffering from a heart attack may present with symptoms such as pain in the shoulder & jaw, hyperventilation, or feeling extremely sweaty, those suffering from a silent heart attack may not show any signs except for a heartburn. Therefore, to make a prompt diagnosis doctors rely on troponin tests. Read on to learn about the significance of troponin tests, how they work, and their role in providing valuable insights into heart health. 

What is a Troponin Test?

A troponin test analyses the presence of a specific heart-related protein called troponin in your bloodstream. Under normal circumstances, these proteins remain confined within the heart muscle cells. However, when heart cells are damaged, such as during a heart attack, troponin leaks into the blood. 

Elevated troponin levels indicate greater heart damage, aiding healthcare professionals in assessing the severity of a heart attack. Advanced versions of this test possess heightened sensitivity, detecting even minute amounts of troponin in the blood. This enhanced sensitivity expedites the diagnosis of heart attacks, especially in cases where other tests yield inconclusive results or symptoms are unclear.

What is Troponin?

Troponin, a protein present in specific muscle types, normally resides within muscle cells and circulates only in minimal amounts in the bloodstream. However, damage to these muscle cells may cause an increase in troponin levels in the blood. Two types of troponin, troponin I (cTnI) and troponin T (cTnT), are particularly indicative of heart muscle damage.

Troponin I is unique to the heart muscle, while troponin T is found in limited quantities in other muscles but has a distinct structure within the heart. Following a heart attack, troponin levels rise rapidly within three to 12 hours, peak around 24 hours after the attack, and remain elevated for several days.

When is a Troponin Test Needed?

The troponin test is commonly employed to diagnose a heart attack. It is also used to monitor angina, a condition that restricts blood flow to the heart, causing chest pain and sometimes leading to a heart attack. 

After being admitted to a hospital for a heart attack, this test may be conducted multiple times within 24 hours to track changes in troponin levels. If you visit the emergency room with symptoms of a heart attack, such as chest pain, discomfort in the back, jaw, arm, or neck, difficulty breathing, nausea, vomiting, fatigue, sweating, or dizziness, you may undergo this test. It aids in evaluating your condition and guiding appropriate medical intervention.

Troponin Test Result Ranges

In individuals without any heart muscle damage, the expected levels of troponin in the blood are typically very low or undetectable. The normal ranges for troponin levels are as follows:

• Troponin I: 0 - 0.04 ng/mL
• Troponin T: 0 - 0.01 ng/mL

When troponin levels are higher than normal, it indicates that damaged heart muscle cells are releasing troponin into the bloodstream. Troponin is considered to be increased if it is 99% higher than the normal value expected in a healthy adult. If your results exceed this threshold, it suggests heart muscle damage.

What Do the Troponin Test Results Mean?

If your troponin levels remain within the normal range for 12 hours after the onset of chest pain, it is unlikely that your symptoms were a result of a heart attack. However, even a small amount of troponin in your blood may indicate some degree of heart damage. If high troponin levels are consistently observed in multiple tests over time, it is likely that you have experienced a heart attack. Other reasons for elevated troponin levels include:

• Blood clots in the lungs
• Sepsis (bloodstream infection)
• Heart failure
• Chronic kidney disease or kidney failure
• Heart damage caused by chemotherapy
• Myocarditis (inflammation of the heart)
• Heart infection
• Traumatic injury to the heart, like a forceful blow to the chest
• Heart damage due to the recreational use of drugs like cocaine

All in all, the troponin test is a crucial tool in diagnosing a heart attack. Over the years, advancements in technology and methods have greatly improved the accuracy, precision, and speed of this test. As a result, it has become one of the most reliable ways to ensure appropriate care for individuals experiencing a heart attack. For more information,

Consult Apollo's Expert Cardiologist

Medically reviewed by Dr Sonia Bhatt.