Troponin elevation occurs in approximately 30%-50% of adult supraventricular tachycardia cases and is usually benign, indicating that routine measurement in all patients is not justified.
What is the clinical significance and appropriate management of troponin elevation in adults with paroxysmal supraventricular tachycardia?
Troponin elevation is common (30-50%) and usually benign in adult SVT, indicating that routine measurement is not justified without ischemic symptoms or high-risk features.
Supraventricular tachycardia (SVT) is a frequent cause of emergency presentations. Troponin elevation is common, but its clinical significance remains uncertain and may trigger unnecessary downstream testing. In this mini-review, we aimed to review the prevalence, mechanisms, prognostic relevance, and management of troponin elevation in adult paroxysmal SVT. A narrative review was conducted using PubMed and EMBASE (2000-2025) with MeSH terms related to SVT and troponin. Eligible studies included original research or registry analyses in adults with paroxysmal SVT. Pediatric and atrial fibrillation/flutter cohorts were excluded. Additional data were obtained from reference lists and expert commentaries. Troponin elevation occurs in approximately 30%-50% of adult SVT cases, primarily reflecting a tachycardia-induced supply-demand imbalance or myocardial stretch, rather than plaque rupture. Short-term registry data suggest potential prognostic associations, but long-term outcomes remain inconsistent and are largely determined by comorbidities and underlying coronary artery disease. Troponin-driven management often leads to increased admissions, consultations, and additional testing without a demonstrable benefit. Troponin elevation in SVT is frequent but usually benign. Routine measurement in all patients is not justified. A selective, risk-based approach - focused on ischemic symptoms, electrocardiogram changes, or high-risk clinical features - offers more appropriate, efficient, and patient-centered care.
Özlek et al. (Thu,) conducted a review in Supraventricular tachycardia. Troponin measurement was evaluated on Prevalence, mechanisms, prognostic relevance, and management of troponin elevation. Troponin elevation occurs in approximately 30%-50% of adult supraventricular tachycardia cases and is usually benign, indicating that routine measurement in all patients is not justified.