Cor Vasa 2025, 67(1):77-81 | DOI: 10.33678/cor.2024.063

High-Sensitivity Cardiac Troponin T Elevation and Paroxysmal Supraventricular Tachycardia. Is it Always Acute Coronary Syndrome?

Serena Miccichè^a, Giuseppe Pelaggi^a, Maria Claudia Lo Nigro^a, Simone Celeste^a, Alice Moncada^a, Olga La Cognata^a, Armando Lo Savio^a, Salvatore Bonanno^a, Paolo Bellocchi^a, Graziella Agnelli^a, Alessio Currò^b

^a Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy

^b Cardiac Intensive Care, IRCCS - P.O Piemonte, Messina, Italy

Background: Paroxysmal supraventricular tachycardia (PSVT) is a common arrhythmia often presenting with symptoms mimicking acute coronary syndrome (ACS). Case presentation: We present a case of a 58-year-old man with PSVT accompanied by chest pain and elevated high-sensitivity troponin (hs-Tn) levels. Coronary angiography revealed slow coronary flow in absence of obstructive disease. The patient's symptoms resolved spontaneously, and echocardiographic findings normalized upon discharge.

Conclusions: This case underscores the diagnostic challenge of individuating ACS and highlights the transient troponin elevation seen in PSVT, potentially due to myocardial ischemia secondary to rapid heart rates. Clinical correlation and adjunctive diagnostic modalities are crucial in guiding management decisions, especially in the absence of significant coronary artery disease.

Keywords: Acute coronary syndrome, Chest pain, High-sensitive cardiac troponin, Myocardial ischemia, Paroxysmal supraventricular, tachycardia

Received: May 21, 2024; Revised: May 21, 2024; Accepted: August 14, 2024; Prepublished online: June 2, 2012; Published: March 1, 2025  Show citation