Troponin is a group of proteins found in heart and skeletal muscles. Elevated levels of troponin T and I can indicate heart damage, but other conditions such as blood infections or organ failure can also cause elevated levels. Troponin tests can help diagnose heart attacks and determine the severity of heart disease.
Troponin actually refers to three proteins made by the body which are classified as I, C and T. These are present in heart muscles and skeletal muscles and are most often at extremely low levels. The troponins present in the heart become medically significant when levels are raised as this could indicate damage to the heart, particularly a heart attack. One of the ways doctors can diagnose if there is a heart attack or other heart damage is to do a test to measure these protein levels.
The basic test for detecting a potential heart attack or other damage measures troponins T and I (TnT or TnI). Both can be measured, or only one can be measured. Usually these levels in the healthy person are barely detectable, but when heart damage has occurred, the proteins are released into the bloodstream and can be seen in a blood sample. Sometimes, when people exercise significantly, they might show detectable, elevated levels of TnT or TnI. This does not indicate heart damage.
It is helpful to use a troponin test when people come to the hospital with chest pain. Failure to detect TnI or TnT would suggest that a heart attack has not occurred and that the pain is due to other causes. When high or troponin levels are present, myocardial infarction (heart attack) may be a reasonable diagnosis. However, there are other circumstances in which troponin levels could increase and these could include congestive heart failure, ventricular or supraventricular tachycardia (abnormal heart rhythms), and cardiomyopathy. When a person has recently had heart surgery or a heart transplant, they may also have elevated levels of these proteins. Procedures such as cardiac ablation could also cause an increase in TnI or TnT.
There are other reasons your troponin could be high, and they include damage to other parts of the body that can indirectly affect the heart. For example, people with blood infections may show elevated levels of TnI or TnT. Another common reason for their presence is when people have direct exposures to poisons such as snake venom. Conditions affecting the lungs such as pulmonary embolism or chronic obstructive pulmonary disease usually show increased troponin levels. Other potential conditions that can increase troponins include all types of strokes, brain hemorrhages, and some types of organ failure.
With these other conditions, especially more serious ones, higher levels of these proteins can indicate a higher risk of death. The tests are basically a way to determine how badly the heart has been affected by the disease. In less severe conditions, TnI or TnT levels may remain elevated for a few weeks and then decline. A return to normal levels may suggest that the heart is healing.
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