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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes elevated troponin T levels?

I am 59, and recently had surgery to remove a very large lipoma from my back. The surgery was done in an operating room due to the large size of the lipoma. I have a severe allergy to latex - type 1 IgE mediated with anaphylaxis, and strict latex precautions were in place. I also have severe asthma secondary to the latex allergy. I do have diabetes - type 2 insulin dependant, and I am post graves disease. I was intebated. When I was extabated, I had trouble breathing. The Anesth gave me an updraft of epinepherine, and I turned blue, and my O2 sat dropped to 70%. The epi was stoped and I recovered, but had severe chest pain. I was admitted and had the chest pain again the following morning. Evidently I showed an atypical rise in my Troponin T levels, with a negative CKMB. I also had some EKG changes. I was transferred to the large medical center, and was evaluated quite extensively - all was negative (stress echo, nuclear stress, )no angiogram was done. I was on a nitro drip and also on heparin IV. Nothing showed except this elevated troponin t level, and they discharged me without a real diagnosis after 24 hours. What do you think happened to me? Could it be related to my latex allergy? ? histamine release?? My tryptase level was 18.5 Could I be allergic to epinepherine? I also showed some fluid around the heart - ? why?
Fri, 28 Dec 2018
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Cardiologist 's  Response
Hi,

Troponin level could be raised because of lots of conditions including severe anaphylaxis, post-surgery apart from cardiac disease.

But an ECG change along with raised Troponin level is highly suspicious of cardiac disease (blockage in arteries of the heart) and also you had the chest pain. Plus you are a Diabetic. I could not think of anything other than a cardiac-related problem.

We do not recommend doing a stress echo in patients with positive Troponin, dynamic ECG change and with chest pain. I will advise you to see another cardiologist and get an Angiography done soon.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Sameer Maheshwari, Cardiologist
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