What Is a Troponin Test?

A blood test used to help diagnose a heart attack

A troponin test is a blood test that can help assess heart damage. It is used along with other diagnostic tests to help evaluate the likelihood of a heart attack.

Your doctor might order a troponin test for you if you experience symptoms such as sudden chest pain, chest tightness, or shortness of breath. The test results generally come back fairly quickly, although urgent treatment for a heart attack might need to be initiated even before the test results return.

Doctor collecting blood sample from the patient
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Purpose of Test 

Troponin levels can become elevated due to damage to the heart muscle. Troponin is a protein in the heart muscle, and when this muscle is damaged, the protein is released into the blood. A heart attack is a blood clot in a coronary (heart) artery, and it causes severe damage to the heart muscle.

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

Indications for a troponin test include:

  • Chest pain 
  • Chest tightness
  • Shortness of breath
  • Pale or blue skin or lips 
  • Sweating and dizziness 
  • Heart palpitations (a sense that your heart is beating rapidly) 
  • Rapid breathing 
  • Confusion, dizziness, or loss of consciousness 
  • Left arm or jaw pain

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 doctor is concerned that you could be having a silent heart attack, you might have a troponin test.

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.

Before the Test 

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 doctor’s office or while you are an inpatient in the hospital, you may have a troponin test.

In 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.

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 doctor 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 doctors know if you are having a heart attack. You will probably have an electrocardiogram (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). 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 doctor’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.

Interpreting Results

The results of your troponin test may be ready in just a few minutes. But it can take up to an hour, depending on the laboratory.

  • Normally, there should be no detectable troponin, or a very low level—below 0.04 nanograms per milliliter (ng/ml) in your blood.
  • A troponin level between 0.04 ng/ml is suggestive of heart disease.
  • A troponin level above 0.4 ng/ml is strongly suggestive of a heart attack.

Keep in mind that the laboratory where your blood is being sent will also include normal ranges for troponin, as these values may differ based on the lab.

Your heart muscle contains troponin C, troponin T, and troponin I. A cardiac troponin test specifically measures troponin T and troponin I.

An elevated troponin level is consistent with a heart attack and heart muscle damage. If you have a normal or undetectable troponin level, it may be repeated if there is a very high suspicion that you could be having a heart attack.

A troponin level may be elevated within a few hours of a heart attack, and the level can remain high for up to two weeks after the event. If you have had a high troponin level, your doctors may repeat the test in a few hours or days to ensure that your level going down, rather than up. 

Follow-Up

If you have a high troponin level, your doctor might initiate emergency treatment for a heart attack. Treatment may include aspirin, intravenous blood thinners, medications to treat blood pressure and cholesterol, among others.

Sometimes a procedure, like a cardiac stent or coronary artery bypass graft (CABG) is needed to restore coronary blood flow.

Follow-up treatment is focused on preventing another heart attack and improving your heart function. Treatments may include a prescription for a blood thinner to take at home, medication to improve your heart function, blood pressure lowering medication, cholesterol lowering medication, glucose management, and cardiac rehabilitation.

A Word From Verywell

A troponin level is a useful test that can help in the diagnosis of a heart attack, which is a medical emergency. You can ask your medical team what your troponin test results are, usually within an hour.

If your doctor has a very high level of concern, you might have a repeat troponin test within a few hours so your medical team can promptly identify changes in your level that may help guide your treatment plan.

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