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Tachycardia, nausea, chest pain, Troponin from 3.0 to 0.25, myocarditis

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I experienced tachycardia briefly, nausea, and chest pain. Troponin was 3.0 at the ER, then 10 12 hours later, then back to 3 after another 12 hours. A cardiac XXXXXXX showed no blockages. The initial diagnosis was acute MI but no cause. I am back in the hospital two weeks later with more chest pain. This time the troponin was 0.04 at admit, 0.42 6 hours later, 0.49 after another 6 hours, and 0.25 after another 6 hours. They are now saying my previous admission was related to myocarditis because of the steep drop rather than an MI.
Can you describe the troponin profile for myocarditis vs myocardial infarction?
There is no family history of cardiac issues. I have recently lost 45 lbs over 6 months through diet/exercise and am 43 yo.
Posted Wed, 2 May 2012 in Heart Attack
Answered by Dr. Rakhi Tayal 4 hours later

Thanks for writing to us.

Cardiac troponin T and troponin I are the most specific and sensitive laboratory markers of myocardial cell injury.A rise of troponins reflects irreversible myocardial cell necrosis which is seen in myocardial infarction. Other clinical conditions that cause abnormal values other than acute coronary disease are myocarditis, pulmonary embolism, acute heart failure, septic shock, and as a result of cardiotoxic drugs as well as after therapeutic procedures like coronary angioplasty, electrophysiological ablations, or electrical cardioversions.

Myocarditis means inflammation of cardiac muscle. Initially when your troponin levels were high the first diagnosis is MI as it needs immediate treatment measures to save the life. Later on the diagnosis was reconsidered and after seeing other test reports, they would have thought of myocarditis as a more probable reason.

I hope my answer and recommendations are adequate and helpful. Waiting for your further follow up queries if any.

Wishing you good health.
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