Diagnosis of Heart attack

You should be admitted to hospital immediately if a heart attack is suspected. You are either admitted to an acute cardiac care unit (ACCU) or to the cardiac catheterisation unit to confirm the diagnosis and begin treatment.

Updated: August 17, 2020

You should be admitted to the hospital immediately if a heart attack is suspected. You are either admitted to an acute cardiac care unit (ACCU) or to the cardiac catheterization unit to confirm the diagnosis and begin treatment. 

The different type of test to diagnose a heart attack include:

Electrocardiography (ECG):

An Electrocardiography is a must-do test in suspected heart attacks. It should be done immediately when a suspected person is admitted to the hospital. An ECG measures the electrical activity of your heart. It produces tiny electrical impulses, each time your heartbeats. An ECG machine records these signals onto paper, to help determine how well your heart is functioning. The test takes around five minutes to perform. It is a painless procedure where electrodes are attached to your arms, legs, and chest. Wires from the electrodes are connected to the ECG machine which records the electrical impulses.
An ECG helps confirm the diagnosis of a heart attack as well as helps determine what type of heart attack you have had. Treatment will be carried out depending on the type of attack.   

Types of Heart Attack:

From the measurement of ECG, heart attacks can be classified as the area of damage inflicted on the heart known as ST-segment.

Acute coronary syndrome:

The acute coronary syndrome has a significant blockage in the coronary arteries. The  three main types of ACS are:

  •     ST-segment elevation myocardial infarction (STEMI)
  •     non-ST segment elevation myocardial infarction (NSTEMI)
  •     unstable angina


ST-segment elevation myocardial infarction (STEMI):

STEMI is caused by a total blockage of the coronary artery, where there is a long interruption to the blood supply. This can cause extensive damage to a large area of the heart.


Non-ST segment elevation myocardial infarction (NSTEMI):

NSTEMI is because of a partial supply of blood to the heart which results in damage to a smaller section of the heart. An NSTEMI can be less serious than a STEMI. But left untreated it can progress to serious heart damage or STEMI.


Unstable angina:

In unstable angina, the blood supply to the heart is also restricted. The heart muscle is preserved in this case as there is no permanent damage. This is still regarded as a medical emergency as it can also progress to serious heart damage or STEMI.


Other tests:

Some tests are usually conducted once your initial treatment has begun and your condition has been stabilized. These include:

Blood tests:

A blood sample will be taken to test for heart proteins known as cardiac markers. These are the enzymes that help regulate chemical reactions that take place in your body. Damage to your heart from a heart attack causes these proteins to slowly leak into your blood. The protein that has to be measure is known as cardiac troponin. Your troponin levels will be measured through a series of blood samples taken for a few days. This will assess the amount of damage to your heart, and also help determine how well you are responding to treatment.


Chest X-ray:

If the diagnosis of a heart attack is uncertain and there are other possible causes of your symptoms, such as a pocket of air trapped between the layers of your lungs, a chest X-ray can be done. A chest X-ray can also be done to check for the complications that have arisen from the heart attack, such as pulmonary edema which is the build-up of fluid inside your lungs.


Echocardiogram :

An echocardiogram is a type of scan that uses sound waves to build up a picture of your heart. This will identify exactly which areas of the heart have been damaged and how this damage has affected your heart's function.


Coronary angiography:

Coronary angiography is done to determine if a blockage or narrowing has occurred in the coronary arteries. This test also helps to locate the exact location of the blockage or narrowing. In this test, a thin tube known as a catheter is inserted into one of the blood vessels in your groin or arm. Using X-rays, the catheter is guided into your coronary arteries. A contrast agent is pumped through the catheter which will show up on X-rays how it flows around and through your heart. This study can help locate the site of any blockage or narrowing.
  


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