False Elevation of Troponin Levels in a Patient With Chest Pain and Significant Psychoemotional Stress

We present a case of a 63-year-old woman who experienced significant psychoemotional stress and was seen in the emergency department for an evaluation of chest pain. She was sent home after reassurance. Subsequent troponin levels came back above the normal range. The patient was called back to the hospital for further assessment, including a potential workup for the exclusion of acute coronary syndrome, given the existing risk factors, symptoms, and elevated cardiac enzymes. The patient has risk factors for atherosclerosis, including hypercholesterolemia, hypertension, and age. She has recently gone through hard personal, emotional, and psychosocial stress. She presented with atypical chest pain, subjective sense of breathlessness, and anxiety. She was reassured, had blood tests ordered, and was discharged after relative improvement. Later that day, her blood test results, which were taken earlier, showed elevated troponin levels. Therefore, she was asked to come back for a cardiology assessment and underwent coronary angiography, which showed normal patent coronary arteries. This case report highlights a patient with a non-cardiac elevation of troponin, emphasizing the importance of considering non-cardiac causes when interpreting elevated troponin levels. The objective of this report is to raise awareness among healthcare professionals regarding the potential causes of false troponin elevation and promote a comprehensive diagnostic approach to minimize unnecessary interventions.