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

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.