Dr. Muhammad Zohaib Siddiq
Cardiology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have been suffering from intense anxiety and was prescribed a daily dose of 50 mg of Sertraline to manage it.
Recently, I have been experiencing chest pain and a burning sensation in my left arm, prompting multiple visits to the emergency room. Each time, tests including ECG, chest X-ray, and troponin I high sensitivity came back normal. Despite this reassurance from doctors that it is not cardiac-related, the arm discomfort persists, although I am able to exercise without chest pain. Additionally, a normal echocardiogram was conducted 10 months ago, and doctors have advised against a stress test, citing my ability to climb 10 floors symptom-free.
Here is a summary of my recent ER visits:
Normal ECG, Troponin I hs at 8 pg/mL
Normal ECG, Troponin I hs at 4 pg/mL
Normal ECG, Troponin I hs at 2 pg/mL
I am feeling extremely anxious about the fluctuating troponin levels and wondering if a drop from eight to two in a month indicates any minor heart damage or if such variation is normal. My physician does not think consulting a cardiologist is necessary.Could you please advise if a variation of approximately 6 in troponin levels over a month is typical and if it can occur in healthy individuals without indicating heart damage? Kindly help.
Thank you.
Hi,
Welcome to icliniq.com.
High-sensitivity troponins are usually positive in low levels and vary from time to time. Since your ECG (electrocardiogram) and Echocardiography are normal and you can climb 10 flights of stairs, your symptoms are not cardiac, but related to anxiety. In the meantime, adopt a healthy lifestyle, consume a Mediterranean diet, avoid smoking oral alcohol, and exercise regularly.. If you have diabetes or hypertension, control these.
I hope this information will help you.
Patient's Query
Hello doctor,
Thank you for the reply.
I do not have any hypertension or diabetes. I do not smoke or consume alcohol. My cholesterol is low. My LDL is 70. I do not have a family history of heart disease.
I am seeking reassurance regarding the fluctuation in Troponin I high sensitivity levels from 8 pg/ml to 4 pg/ml to 2 pg/ml. Could this variance be considered normal? Moreover, can I confirm that there was no heart damage when my troponin levels were at 8?
The normal range for Troponin I hs, as per my report, is 0 to20 pg/ml. I have attached the report for your reference. Kindly help.
Thank you.
Hi,
Welcome to icliniq.com.
I have gone through your reports (attachments have been removed to protect the patient’s identity) and it is normal. Such small variations within the normal range are common and do not indicate heart attack. Adopt a healthy lifestyle and focus on the primary prevention of cardiac disease.
I hope this information will help you.
Thank you.
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Cardiology
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