High-Sensitivity Troponin Elevation in a Young Woman with Typical Chest Pain: The Heart of the Matter

In the era of high-sensitivity troponin, minor elevations are often attributed to noncardiac etiologies. However, in patients who present with characteristic symptoms, any troponin elevation is concerning. We detail a case of a 37-y-old woman who presented to an outside hospital with typical chest pain and had a mild elevation in high-sensitivity troponin. Given her overall stability, she was discharged with outpatient cardiology follow-up. ⁸²Rb PET/CT myocardial perfusion imaging test demonstrated a large, reversible anteroseptal perfusion defect. Coronary angiography revealed severe (80%) stenosis in the proximal left anterior descending artery treated with a single stent. This case highlights the need to have a high index of suspicion in young people with minor troponin elevations and pursue timely imaging.