Do Elevated Troponins during Supraventricular Tachycardia (SVT) Predict the Presence of Coronary Artery Disease?

Copyright: © 2013 Schmitz G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. More than one third of patients will have chest pain associated with Supraventricular Tachycardia (SVT). It is unclear if Troponin markers in this setting are useful in predicting which patients will have Coronary Artery Disease (CAD). Elevated Troponins are not pathognomonic for CAD or acute coronary syndrome. In fact, modest Troponin elevation is well documented in patients with SVT with normal coronary angiography and is thought to be due to cardiac stretch, poor diastolic perfusion, and/or coronary artery vasospasm. Routine ordering of Troponin in patients with SVT who convert easily to sinus rhythm could potentially result in unnecessary testing and admission. Given the high incidence of Troponin elevation in patients with SVT, we sought to evaluate the literature and determine the prognostic value of Troponin assays in patients presenting to the emergency department with SVT.