Why athletes' blood tests can look like a heart attack even when they're fine
The cardiac troponin response following physical exercise in relation to biomarker criteria for acute myocardial infarction; the North Sea Race Endurance Exercise Study (NEEDED) 2013.
Not medical advice. For informational purposes only. Always consult a healthcare professional. Terms
After a long bike race, many athletes' blood shows high levels of heart proteins — so high that doctors would normally think they had a heart attack. But they didn't. This happens more in women and with one test (hs-cTnT) than another (hs-cTnI).
Surprising Findings
Over 95% of healthy athletes met the clinical threshold for heart attack using hs-cTnT — despite having no cardiac injury.
People assume troponin elevation = heart damage, but this shows it can be a normal response to extreme exercise — especially with one specific test.
Practical Takeaways
If you're an endurance athlete and your troponin levels spike after a race, don't panic — but do tell your doctor you just completed intense exercise.
Not medical advice. For informational purposes only. Always consult a healthcare professional. Terms
After a long bike race, many athletes' blood shows high levels of heart proteins — so high that doctors would normally think they had a heart attack. But they didn't. This happens more in women and with one test (hs-cTnT) than another (hs-cTnI).
Surprising Findings
Over 95% of healthy athletes met the clinical threshold for heart attack using hs-cTnT — despite having no cardiac injury.
People assume troponin elevation = heart damage, but this shows it can be a normal response to extreme exercise — especially with one specific test.
Practical Takeaways
If you're an endurance athlete and your troponin levels spike after a race, don't panic — but do tell your doctor you just completed intense exercise.
Publication
Journal
Clinica chimica acta; international journal of clinical chemistry
Year
2018
Authors
Ø. Skadberg, Ø. Kleiven, S. Ørn, M. Bjørkavoll-Bergseth, T. Melberg, T. Omland, K. Aakre
Related Content
Claims (5)
High-volume endurance training is not associated with an increased incidence of acute myocardial infarction.
After riding a long bike race, people’s hearts release more of a protein called troponin, especially women, and this spike happens faster in some tests than others.
After a long bike race, most people’s blood tests show troponin levels high enough to be diagnosed as a heart attack—even though their hearts are actually fine.
After a long bike ride, the troponin T blood test is more likely to show a heart attack signal than the troponin I test—even when the heart is healthy.
The blood tests used to diagnose heart attacks can’t tell the difference between a healthy athlete’s post-race troponin spike and a real heart attack.