[Supraventricular tachycardia as a cause of elevated troponin I in a patient with normal coronary arteries].

The authors describe otherwise healthy 69-year-old man admitted to the hospital with supraventricular tachycardia (193/min) accompanied by chest pain and marked ST depression on ECG. Sinus rhythm was restored after verapamil (5 mg i.v.) administration. Symptoms resolved and ECG returned to normal. However, elevation of troponin I level (1.2 ng/ml) was observed a few hours later. Echocardiography as well as coronary angiogram were normal. In electrophysiologic study typical AVNRT was diagnosed and successful ablation of the slow pathway was performed. The authors present a review of current literature on myocardial ischaemia due to supraventricular tachycardia despite normal coronary arteries. In conclusion authors suggest that elevated troponin levels may reflect subendocardial ischaemia and should prompt RF ablation of underlying arrhythmia.