Case report—very high cardiac troponin I concentrations following endurance exercise: a complex finding

There is currently no consensus on the clinical interpretation of exercise-induced cTn elevations. Our athlete showed a very high cTnI concentration post-exercise, without evidence of ischaemia or myocardial infarction. Accordingly, we summarize other explanations that may have caused the elevated cTnI concentrations, including (1) progression of coronary atherosclerosis, (2) other underlying cardiac conditions, (3) exposure to exercise-related cardiac stress, (4) dehydration, and (5) cardiac vulnerability. This case with a large intra-individual difference in post-exercise cTn concentrations illustrates the challenging interpretation of exercise-induced cTn elevations. Future studies examining the underlying mechanisms of exercise-induced cTn release and its clinical sequelae are warranted to improve differentiation between physiological and pathological cTn elevations in athletes.