by Wood D

Diagnosis of Heart Attack

A heart attack is a medical emergency. If you think you are having a heart attack, call for emergency medical services right away.

Tests to Diagnose a Heart Attack

Electrocardiogram

Blood Tests

Coronary CT Angiography

On the way to, or within minutes of your arrival at the hospital, you will be hooked up to an electrocardiogram (EKG), which monitors your heart's electrical activity. A healthy heart creates a specific pattern on an EKG. A heart attack and heart damage will cause disruptions to this pattern.
Once you get to the hospital, other diagnostic tests will be done to confirm if you had a heart attack. Tests may include:
Blood tests look for markers of a heart attack. Specifc substances are found in the blood within hours or days after a heart attack. Blood tests may need to be repeated in order to track the enzymes. Progressive elevation of the enzymes indicates heart cell death and heart muscle damage. Substances include:
  • Troponins—a group of proteins involved in heart muscle contraction
  • Creatine kinase (CK)—can be used if troponin testing is unavailable
  • Myoglobin—can be useful for diagnosis when used in combination with other blood tests
Blood tests can also be used to evaluate glucose, electrolyte, and cholesterol levels, as well as blood clotting time.
A coronary CT scan uses an injected dye to detect calcium deposits and cholesterol plaques in the coronary arteries. A catheter is threaded through a distant artery to a coronary artery. The injected dye highlights areas where blood flow to the heart is reduced or completely blocked.
If narrowing or blockage is found, it can be relieved with a balloon, stent, or other procedure.

Tests to Evaluate Heart Damage

Heart attacks can cause permanent heart damage. Once you are stabilized, it is likely you will have other tests to assess damage or look for any underlying causes of your heart attack. Tests may include:
  • Chest x-ray —Detects heart enlargement or congestion in the lungs. This test can help diagnose heart failure or an unrelated lung condition
  • Exercise stress test —Records the heart's electrical activity during increased physical activity. It may be coupled with other tests that detect blood flow through the heart. People who cannot exercise may be given IV medication that simulates the effects of physical exertion.
  • Imaging tests:
    • Echocardiogram —Ultrasound detects abnormalities in the heart muscle by highlighting areas of poor blood flow.
    • MRI scan —Use of magnetic waves to make two- or three-dimensional pictures of the heart.
    • Nuclear scanning—Contrast material is injected into a vein and observed as it is absorbed by the heart muscle. The areas with diminished blood flow show up as dark spots on the scan.
    • SPECT scan—Evaluates blood flow to the heart muscle.

References

Acute coronary syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 31, 2014. Accessed April 4, 2014.

How is a heart attack diagnosed? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/heartattack/diagnosis.html. Updated December 17, 2013. Accessed April 4, 2014.

ST-elevation myocardial infarction (STEMI). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 31, 2014. Accessed April 4, 2014.

Symtoms and diagnosis of heart attack. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/HeartAttack/SymptomsDiagnosisofHeartAttack/Symptoms-and-Diagnosis-of-Heart-Attack%5FUCM%5F002041%5FArticle.jsp. Updated March 22, 2013. Accessed April 4, 2014.

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