Hello, Brief answer: Troponin level may vary according to acute heart insult also from lab to lab. Sometimes false positive troponin present. Explanation: My opinion is that troponin level is used to diagnose acute coronary syndrome. Chest pain and dynamic or ischemic changes in EGC are an indication to measure troponin. So, it is not any time investigation such as CBC. Positive troponin points to myocardial injury, so anti-ischemic measurements should be initiated. Sometimes false positive troponin presents with renal failure for example. Also, variation in lab results may be an error in lab procedures. In your case, having no past history of chest pain makes diagnosis of ischemic heart is far-fetched. I suggest my patients the following if positive troponin. Do an EGC, echocardiogram and if those suggest myocardial ischemia, anti-ischemic measures are initiated on spot. The information provided by you is not sufficient to provide a good opinion. If someone comes to me with this condition I would ask them about other risk factors to develop ischemic heart disease, smoking, obesity, family history, etc. Also ask about diabetes as in diabetics silent ischemia happens (that means without chest pain). Conclusion: I suggest you do your thallium study as soon as possible to see if any ischemia develops in your heart and so treat accordingly. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Mahmmad Gamal