<p>WHAT DOES THIS MEAN? My H is at urgent care with what he assumed was another flare up of his chronic reflux but because he has a terrible family history of heart disease, they always test his enzymes. They are always fine but today they are as stated above and they want to observe him for a few hours. He will not let me go up there because he doesn’t want to worry about me worrying about him, plus the 13 yo would have a nervous breakdown.</p>
<p>He says that the cocktail of reflux meds they gave him have him feeling 100% better and his EKG is fine, as is his blood pressure. So, what does elevated enzymes mean in this context? He says they expect to send him home in a couple of hours. Anyone who can explain this to me?</p>
<p>But that won’t stop me from telling you what I know.</p>
<p>When one has a heart attack, certain enzymes in the blood kick up and have a party. They test the blood to determine if in fact a heart attack occurred. If DH is at the “high end of average,” it sounds to me like that’s NOT a heart attack. He’s still within average, which is a good place to be. If his enzymes were in fact elevated, they’d say so, and they’d be treating him differently.</p>
<p>Thanks, VH. The second test was completely normal, so they think the first test was compromised somehow. But he has to see his regular doc and have a stress test, etc.</p>
<p>The true cardiac enzymes, such as CKMB, are seldom tested any more because they have been obsoleted by better tests. </p>
<p>The cardiac “enzyme” usually tested today is cardiac troponin. It’s not really an enzyme but is a structural protein of muscle tissue. The amount of cardiac troponin found in the blood of a healthy person is very close to zero. So even very small amounts of it leaking into the blood suggest that there is some degree of damage to the heart muscle occurring. </p>
<p>A rising or rising and falling elevated level of c-troponin usually means a heart attack. A stable low-level elevation may mean there is not a heart attack now but the patient is at risk of a future adverse cardiac event. </p>
<p>There are a few other things that can also cause an elevation in the troponin: some chronic kidney diseases, cocaine abuse, extremely vigorous exercise (such as running a marathon), an infection of the heart muscle, or mechanical damage to the heart muscle from say a bad blow to the chest. But in a large majority of cases an elevated troponin will mean that something bad is happening involving the heart, and the doctors will follow-up with it on that basis.</p>
<p>An elevated troponin test that returns to normal in just a couple of hours or so usually means that there was an error with the first test. Because troponin levels do not normally drop that quickly after a cardiac event. The fact that your husband’s level returned to normal quickly suggests that may have been the case here. But it may also be a warning shot across the bow so to speak, especially if he has other risk factors such as old age, overweight, smoking, diabetes, high cholesterol, lack of exercise, etc.</p>
<p>Thanks, coureur. He had a all-clear stress test and check up just this past summer but of course they will check everything again. He is somewhat overweight but the real risk factors are that his parents, both NON-overweight people, died quite young of heart disease. He doesn’t smoke, while they did.</p>
<p>Believe me, he will do whatever he is advised at this point because of his family history. He and his siblings at this point have lived past their parents ages and want to keep it that way.</p>
<p>The other part of it, EK, is that they were the “working poor”, so while they had jobs, they didn’t have access to good medical care that might have caught problems sooner. It’s part of why DH never misses an appointment. But either way, we want to make sure this wasn’t anything to be alarmed about, and if it WAS, what we need to do from here on.</p>