CASE REPORTS

Treat the patient not the blood test: the implications of an increase in cardiac troponin after prolonged endurance exercise

G Whyte¹, N Stephens², R Senior², K George¹, R Shave³, M Wilson⁴, S Sharma⁵

¹ Research Institute for Sport and exercise Science, Liverpool John Moores University, Liverpool, UK
² Department of Cardiology, Northwick Park Hospital, London, UK
³ Centre for Sports Medicine and Human Performance, Brunel University, Uxbridge, UK
⁴ CRY Centre for Sports Cardiology, Olympic Medical Institute, Northwick Park Hospital, Watford Road, Harrow, Middlesex, UK
⁵ Department of Cardiology, Lewisham University Hospital, Lewisham, UK

Professor G Whyte, Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool L3 2ET, UK; gregwhyte27{at}yahoo.co.uk

Collapse after prolonged endurance exercise is common and usually benign. This case study reports a triathlete who suffered a vaso-vagal associated collapsed after exercise. Misdiagnosis of myocardial injury in the presence of elevated cardiac troponins and ECG anomalies led to inappropriate management and highlights the difficulty in treating the collapsed athlete following arduous exercise.

Keywords: myocardial damage; Ironman triathlon; troponin

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