Your Good Health: High troponin levels follow food poisoning

Dear Dr. Roach: I am a 77-year-old man who apparently suffered a case of food poisoning. I say apparently because no cause was ever discovered for the uncontrollable vomiting and diarrhea that lasted for a whole day, then reoccurred briefly the following morning.

A level above 0.04 ng/mL is often used as the cutoff for the “normal” range, but depending on the assay and population studied, a few healthy people may have levels above this. People with heart attacks may have troponin levels in the hundreds or thousands. The higher the troponin level, the more muscle damage there is.

I found a long list of reported causes of elevated troponin levels, but gastroenteritis was not on the list. I suspect your body was working so hard to fight off the infection without enough fluid that your heart needed more oxygen-carrying blood than it got, leading to tiny amounts of injury to the heart muscle despite normal heart arteries. You can lose a lot of fluid with vomiting and diarrhea, and people at age 77 don’t have as much reserve as they did when they were younger.

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