Troponin elevation in supraventricular tachycardia: A narrative review

Table 3 Practical tips and tricks for troponin testing in adult supraventricular tachycardia

Practical tips and tricks
Do not test routinely in young, low-risk patients with typical paroxysmal supraventricular tachycardia and no ischemic symptoms or electrocardiogram changes after conversion
Remember that most troponin elevations reflect demand ischemia or myocardial stretch, not plaque rupture
Short-term risk is modest and confined to selected populations (older age, coronary artery disease, diabetes, significant comorbidities)
Long-term outcomes are inconsistent, and elevations are often prognostically neutral once comorbidities are accounted for
Always prioritize arrhythmia management first – terminate supraventricular tachycardia, relieve symptoms, and then decide whether troponin adds value
Interpret troponin within the universal definition of myocardial infarction framework, using sex-specific 99th percentiles and delta algorithms, and avoid overdiagnosis of ACS
Positive troponin in the absence of ACS features should prompt tailored outpatient evaluation (coronary computed tomography angiography, stress test, echocardiography) rather than reflexive invasive testing
Balance is key: Avoid unnecessary admissions and procedures, but remain vigilant for true ischemic events

ACS: Acute coronary syndrome.