Many laboratory tests are routinely ordered for reassurance. We almost always order a hemoglobin and pregnancy test when a patient has syncope, despite knowing the vast majority will be normal.

These tests are accurate and should prompt further investigation if they are abnormal. Unfortunately, that is not the case for the once-vaunted, much-studied troponin.

The troponin is a very sensitive test and can be unwieldy in certain hands, and that makes for a dangerous combination.

Indications for ordering troponins have expanded from symptoms such as chest pain and shortness of breath to a variety of others like weakness, confusion, and of course, palpitations.

Patients with supraventricular tachycardia (SVT) in particular frequently have troponins drawn.

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