# Multivessel Coronary Artery Disease Presenting as Supraventricular Tachycardia in an Elderly Woman: A Case Report

## TL;DR

An elderly woman's supraventricular tachycardia led to discovery of severe coronary artery disease, showing troponin elevation may indicate obstructive disease.

## Contribution

Highlights the importance of not attributing troponin elevation during SVT solely to demand ischemia in high-risk patients.

## Key findings

- A 71-year-old woman with SVT had elevated high-sensitivity troponin levels.
- Coronary angiography revealed significant multivessel coronary artery disease.
- The case suggests troponin elevation during SVT may indicate underlying obstructive CAD.

## Abstract

Troponin elevations occurring during supraventricular tachycardia (SVT) are often interpreted as “demand ischemia” rather than indicative of obstructive coronary artery disease (CAD). Nonetheless, differentiating transient tachycardia-related injury from an acute coronary syndrome (ACS) can be difficult. We report a case of a 71-year-old woman whose SVT episode ultimately served as the first clue to underlying severe CAD. Her progressively rising high-sensitivity troponin (HS-Tn) required further evaluation. The patient subsequently underwent coronary angiography that revealed significant multivessel coronary artery disease. This case highlights that escalating HS-Tn levels following SVT should not be automatically attributed to demand ischemia, particularly in patients with cardiovascular risk factors.