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They are measured in the blood to differentiate between unstable angina and myocardial infarction (heart attack) in people with chest pain or acute coronary syndrome. A person who recently had a myocardial infarction has areas of damaged heart muscle and elevated cardiac troponin levels in the blood. [15]
Differential diagnosis of troponin elevation includes acute infarction, severe pulmonary embolism causing acute right heart overload, heart failure, myocarditis. Troponins can also calculate infarct size but the peak must be measured in the 3rd day. After myocyte injury, troponin is released in 2–4 hours and persists for up to 7 days.
Chest pain with features characteristic of cardiac origin (angina) can also be precipitated by profound anemia, brady-or tachycardia (excessively slow or rapid heart rate), low or high blood pressure, severe aortic valve stenosis (narrowing of the valve at the beginning of the aorta), pulmonary artery hypertension and a number of other conditions.
Elevated troponin levels indicate the heart is damaged and doctors can use this measure to diagnose heart attack. “Everybody sprung into action,” Hutt says.
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Dr. Jean adds that other heart attack symptoms include pain in the shoulder, arm, neck, jaw, back and stomach. "People may also experience nausea or vomiting, heartburn, dizziness, sweating ...
When calcium binds to the troponin C, it causes conformational changes which lead to dislocation of troponin I. Afterwards, tropomyosin leaves the binding site for myosin on actin leading to contraction of muscle. The letter I is given due to its inhibitory character. It is a useful marker in the laboratory diagnosis of heart attack. [2]
Heart-type fatty acid binding protein is another marker, used in some home test kits. Elevated troponins in the setting of chest pain may accurately predict a high likelihood of a myocardial infarction in the near future. [15] New markers such as glycogen phosphorylase isoenzyme BB are under investigation. [16]