Article Text

Reminder of important clinical lesson
Treat the patient not the blood test: the implications of an increase in cardiac troponin after prolonged endurance exercise
  1. Gregory Whyte1,2,
  2. Gregory Whyte1,2,
  3. Nigel Stephens3,
  4. Roxy Senior3,
  5. Keith George1,
  6. Robert Shave4,
  7. Mathew Wilson5,
  8. Sanjay Sharma6
  1. 1
    Liverpool John Moores University, Research Institute for Sport and Exercise Science, Henry Cotton Campus, Truman Street, Liverpool, L3 2ET, UK
  2. 2
    CRY Centre for Sports Cardiology, Olympic Medical Institute, Northwick Park Hospital, Harrow, HA1 3UJ, UK
  3. 3
    Northwick Park Hospital, Watford Road, Harrow, HA1 3UJ, UK
  4. 4
    Brunel University, Uxbridge, London, UB1, UK
  5. 5
    Wolverhampton University, Gorway Road, Walsall, WS1 3BD, UK
  6. 6
    Kings College Hospital, Denmark Hill, London, SE1, UK
  1. gregwhyte27{at}


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.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests: None.