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Q. I have a low heart rate with elevated troponin and palpitations. What is my problem?

Answered by
Dr. Amiya Kumar Chattopadhyay
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Aug 29, 2020

Hello doctor,

I have been having dizziness and lightheadedness. I fainted a couple of weeks ago and I am having palpitations regularly. My resting HR (heart rate) is 40s-50s and I am not at all athletic, I often feel bad when it drops low. I had a blood test for Troponin and the levels were elevated, but three hours later they repeated the test and the levels were normal. Why would they decrease that quickly? Everything I have read says they decrease slowly over a few days. I have had three EGCs all with ST depression, but then the fourth one came back normal. My doctors do not seem concerned but I am not feeling well and all the anomalies concern me. I have also got syringomyelia at T4-T5 level in the spine and I know this can cause problems with heart nerves. What do you think the problem is?



Welcome to

You had fainted, palpitations, and resting HR (heart rate) 40s-50s. I suggest you to do 24-hour Holter monitoring to evaluate the cause. Based on the report, subsequent action could be taken.

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Thank you doctor,

And do you know why Troponin would be elevated and then back to normal after three hours?



Welcome back to

Troponin is a group of proteins found in skeletal and heart muscle fibers. There are three types of troponin C, I, and T. There is a little or no difference in troponin-C between skeletal and cardiac muscles. Troponin I and T are cardiac-specific and elevated in the blood within three to four hours after injury to cardiac muscles and may remain elevated to 10-14 days. Troponin may be elevated unrelated to the heart. Among number of causes one is due to physical exercise which may help you to understand your query. Due to physical exercise troponin release as early as 30 minutes of sustained exercise and may return to normal six hours post-exercise.

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