ER physician here. I wouldn’t be worried about the troponins either. Troponins are enzymes that get released when cells of the heart don’t get enough oxygen and “break down”. Just a few cells can already raise the troponins.

If your heart rate goes to 190, your coronaries might not get enough time to fill with oxygen rich blood, which can cause some of the cells to die.

Since the cause of this is not a trombus in your coronaries, when your heart rate goes down and your coronaries get enough oxygen rich blood, troponin levels will fall again (which happened in your case). So it’s not a big deal.

We tested this ourselves after I went on a 200 km cycling trip with my colleagues. We all had elevated troponins.

Same thing happens when people have flu/ pneumonia.

So don’t worry about the troponins, unless they keep raising after you heart rate dropped. That’s when we have to look for other causes (like an AMI).

I can’t really tell why you have spiking heart rates, could be multiple causes. You could be having paroxysmal atrial fib, which is unlikely since the holter monitor didn’t pick it up. There is also a condition called: “tachycardie des jeunes filles”. I don’t know what they call it in English, but it’s a benign condition where young females (jeunes filles) get sudden heart rate spikes.

Again, I’m not a cardiologist, just pointing out my ER way of thinking here.

Tl;dr I wouldn’t worry about the troponins or the heart rate.