[1]¿p#1 Background: Patients with paroxysmal supraventricular tachycardia (PSVT) and elevated cardiac troponin (cTn) levels often require further evaluation for coronary artery disease (CAD), which guides clinical management. Objective: To characterize patients with PSVT and elevated cTn values, and to evaluate the association with coexisting CAD as well as the probable underlying mechanisms of troponin elevation. Methods: We recorded demographic characteristics, main symptoms, underlying comorbidities, chronic antiarrhythmic medication, tachycardia duration, systolic blood pressure (SBP), heart rate (HR) and laboratory values on admission. We also documented the type of cardioversion and the total number of patients visiting the Emergency Department (ED) or admitted to the Cardiology department due to PSVT over the past 4 years. Hospitalized patients with at least one cardiovascular risk factor and troponin elevation underwent CAD evaluation. Patients were divided into two groups based on the presence of elevated troponin values. Results: 58/120 patients presenting to the ED with PSVT had elevated cTn values. Retrosternal chest pain, absence of a previous history of SVT, higher admission heart rate and lower SBP were identified as independent risk factors for elevated cTn.  An optimal admission heart rate cut-off of 165 bpm was identified for predicting elevated cTn levels, with a sensitivity of 63.8% and specificity of 69.5%. 25 patients with elevated cTn underwent further evaluation for CAD, with only one patient showing significant disease. Conclusion: Retrosternal chest pain, no prior history of SVT, higher admission HR and lower SBP are independently associated with elevated troponin values after an episode of PSVT. Elevated cTn values in these patients is more likely related to myocardial oxygen-demand mismatch rather than the presence of CAD. Keywords: Paroxysmal supraventricular tachycardia, Cardiac troponin, Coronary Artery Disease, Heart rate, Systolic blood pressure, Antiarrhythmics, Mental-stress induced myocardial ischemia