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Heart Attack Diagnosis

Benjamin McDonald, MD, edited by Ann Witt, MD

heart echoIt is important that you call 911 if you find yourself (or someone that you are with) experiencing symptoms or the warning signs of a heart attack. The longer treatment is delayed, the more likely it is that irreversible damage will occur to your heart muscle. At the hospital, the doctor will ask you questions and perform tests to determine whether or not the symptoms you are feeling are truly being caused by a heart attack. The doctor will ask questions about your medical history and risk factors for heart disease such as whether you smoke, your family history, and cholesterol history. One or more of the following tests to determine whether or not you have actually had a heart attack, may be performed:

  • ECG. An ECG (also referred to as an EKG or electrocardiogram) measures the electrical activity of the heart. Changes in the heart's activity levels can signal a heart attack. The EKG also monitors your heart rate for dysrhythmias (irregular heart rates) that can occur during a heart attack. Dysrhythmias may result in the inability of the heart to pump enough blood throughout your body.
  • Blood Tests. Heart muscle cells contain unique enzymes that help them to function. When heart muscle cells are lysed (broken) during a heart attack, the contents of the cells, including these enzymes, get spilled into the bloodstream. Doctors can measure the levels of these heart muscle enzymes in your blood to determine if you have had a heart attack.
  • Echocardiography(ECHO). Echocardiography is an ultrasound of the heart. An ECHO is particularly useful at identifying which heart structures have been damaged during a heart attack and the amount of function lost (i.e. how well is the heart able to pump blood after a heart attack).
  • Stress Test: If your doctor is uncertain whether your chest pain is caused by your heart, he or she may perform a stress test. There are several types of stress tests, but their purpose is similar: to observe your heart (through EKG, ECHO, or nuclear imaging techniques) while it is under stress (i.e., during exercise or after taking medication that causes your heart to work harder). During a stress test the doctor is looking for changes that show your heart is not getting enough blood flow to some of its muscles.