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
On the way to, or within minutes of your arrival at the hospital, you will be hooked up to an
(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.
Other diagnostic tests will also be done to confirm if you had a heart attack. Tests may include:
Blood tests look for markers of a heart attack. Specific 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 angiogram uses an injected dye to detect calcium deposits and cholesterol plaques in the coronary arteries. A catheter is threaded through a distant artery in the groin or wrist and passed 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. After 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:
—Detects heart enlargement or congestion in the lungs. This test can help diagnose
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.
—Ultrasound detects abnormalities in the heart muscle by highlighting areas of poor blood flow.
—Use of magnetic waves to make 2- or 3-dimensional pictures of the heart.
—Contrast material is injected into a vein and observed as it is absorbed by the heart muscle. The areas with diminished blood flow appear as dark spots on the scan.
—Evaluates blood flow to the heart muscle.
Acute coronary syndromes. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116779/Acute-coronary-syndromes. Updated February 22, 2017. Accessed March 2, 2017.
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. Updated January 27, 2015. Accessed March 2, 2017.
ST-elevation myocardial infarction (STEMI). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115392/ST-elevation-myocardial-infarction-STEMI. Updated January 30, 2017. Accessed March 2, 2017.
Symptoms 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#.VxEZYE2FMdU. Updated September 16, 2016. Accessed March 2, 2017.