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Case Reports
. 2025 Jan 6;17(1):e77018.
doi: 10.7759/cureus.77018. eCollection 2025 Jan.

Chest Pain With Significantly Elevated Troponins: Be Wary of False Positives

Taarunya T Narayanan  1 , Tamara Naneishvili  1 , William Moody  1 , John Townend  1 , Peter Ludman  1
Affiliations
Case Reports

Chest Pain With Significantly Elevated Troponins: Be Wary of False Positives

Taarunya T Narayanan et al. Cureus. .

Abstract

High-sensitivity cardiac troponins are considered a gold standard for diagnosing acute myocardial infarction and myocardial injury. However, the occurrence of false positives needs to be kept in mind. We describe the clinical challenges in diagnosing a 45-year-old woman who repeatedly presented to the emergency department with atypical chest pain and extremely elevated high sensitivity troponin I (HsTnI), despite normal imaging including cardiac MRIs and invasive coronary angiograms, on multiple occasions. This report emphasizes the importance of carefully interpreting elevated troponin levels, especially when clinical findings and further investigations do not support a cardiac origin for troponin (Tn) elevation.

Keywords: assay interferance; atypical chest pain; covid-19 vaccine; false-positive troponins; macrotroponin.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Gadolinium enhanced cardiac MRI during first in-patient episode
Figure 2
Figure 2. Invasive coronary angiogram.
Figure 3
Figure 3. Repeat gadolinium enhanced cardiac MRI
Figure 4
Figure 4. PET-CT images.
Figure 5
Figure 5. Results of the linearity experiment.
See this image and copyright information in PMC

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