Your heart releases cardiac enzymes (cardiac biomarkers) when there’s heart damage or stress. Troponin levels rise after a heart attack. Elevated heart enzyme levels can also indicate acute coronary syndrome or ischemia. Healthcare providers use enzyme marker tests (blood tests) to measure cardiac enzymes.

What are cardiac enzymes (cardiac biomarkers)?

When your heart experiences damage or stress due to lack of oxygen, it releases substances called cardiac enzymes into the bloodstream. Enzymes are proteins that help your body manage metabolism and other chemical processes. 

What is a cardiac enzyme marker test?

An enzyme marker test is a blood test to measure specific biological markers (biomarkers) in your blood. High levels of cardiac enzymes can be a sign of a heart attack or stress on the heart.

How do healthcare providers use cardiac biomarkers?

Increases in cardiac enzymes can indicate acute coronary syndrome (ACS), myocardial ischemia or the presence of injury to the heart muscle.

Treatments for these conditions vary. An accurate diagnosis is critical to ensuring that you receive the appropriate care.

What’s the purpose of cardiac biomarkers?

Healthcare providers measure cardiac marker levels to:

  • Screen for heart damage and other problems.
  • Diagnose heart conditions that cause symptoms like chest pain and shortness of breath.
  • Monitor how well heart medications and heart surgery work.
  • Predict a prognosis (outlook) for various heart conditions.
Where do you get a cardiac enzyme marker test?

A cardiac enzyme marker test requires a blood draw. The blood draw takes just a few minutes. In an emergency situation, the blood draw takes place in an emergency department or hospital. For nonurgent situations, the test may take place at your healthcare provider’s office or a blood-testing lab.

There are different types of cardiac biomarkers. All of them are enzymes or proteins. Elevated heart enzymes may show that you have cardiovascular disease or other heart problems.

A biomarker test for troponin is the primary test healthcare providers use to detect heart damage from a heart attack or ACS. Troponin levels can rise for up to 12 hours after a heart attack. They stay elevated for up to two weeks. You may get several cardiac enzyme tests spaced several hours or days apart to measure these biomarkers.

Healthcare providers may also test for natriuretic peptides (NPs) that may be elevated in conditions like heart failure. Providers can measure various types of peptides, but they most commonly use N-terminal proBNP (NT-proBNP) in the assessment of strain on the heart due to heart failure.

Your healthcare provider may order a cardiac enzyme test if you have symptoms of a possible heart problem. These symptoms include:

  • Chest pain.
  • Dizziness.
  • Nausea.
  • Profuse sweating.
  • Shortness of breath.
  • Heart failure exacerbation.
  • Jacob R, Khan M. Cardiac Biomarkers: What Is and What Can Be (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6957084/)Indian J Cardiovasc Dis Women WINCARS. 2018 Dec;3(4):240-244. Accessed 6/3/2024.
  • Strimbu K, Tavel JA. What are biomarkers (https://pubmed.ncbi.nlm.nih.gov/20978388/)Curr Opin HIV AIDS. 2010 Nov;5(6):463-6. Accessed 6/3/2024.
  • The Society for Cardiovascular Angiography and Interventions. Cardiac Biomarker Blood Test (https://www.secondscount.org/test/cardiac-biomarker-blood-test). Last reviewed 11/10/2022. Accessed 6/3/2024.
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