This case highlights that positive troponin results can be caused by rigorous exercise and heterophile antibodies, emphasizing the need to interpret troponin assays within the clinical context.
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May prompt heterophile antibody testing in athletes with troponin elevation; leaves open prevalence and diagnostic impact.
In this case report, we describe a young athletic male with a family history of early sudden cardiac death who presented with atypical chest pain and was found to have a positive serum troponin. Although his symptoms resolved without intervention, workup revealed hypertension, hyperlipidemia, mild left ventricular hypertrophy, non-obstructive coronary artery disease, and the presence of serum heterophile antibodies. Ultimately, it was concluded that his rigorous exercise regimen as well as the presence of heterophile antibodies may have contributed to his positive serum troponin. This case serves as a reminder of the nonspecific diagnostic value of modern troponin assays, and that the results of these tests should always be incorporated into the clinical context.
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Manjunath et al. (2018) studied this question.
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