Heart Attack and Acute Coronary Syndrome
When a person presents with acute coronary syndrome , it is usually not clear whether the symptoms indicate that the patient is having a heart attack or whether the blockage is only temporary. A number of tests are available to help decide whether a heart attack has occurred.
The diagnosis of a heart attack may be made by changes seen on an electrocardiogram (ECG) and by a number of blood tests. An ECG is performed within the first few minutes after a person with acute coronary syndrome arrives in the emergency room. It can recognize changes that prove that a severe heart attack has occurred, but this diagnostic change is only seen in the more severe heart attacks. More commonly, the ECG only confirms that the heart is not getting enough blood or has non-specific changes that do not prove that a heart attack has occurred. Those with the most severe ECG changes (termed ST elevation, referring to increase in the height of the line on the ECG linking the S and T parts of the ECG tracing) usually have a major clot in an artery supplying the heart and should be treated rapidly with either drugs or coronary angioplasty to remove the clot.
In many patients with acute coronary syndrome , blood tests are needed to tell whether an AMI has occurred. The blood tests provide a measure of heart muscle damage. When heart muscle dies, the dead cells release chemicals into the blood such as CK-MB, myoglobin, and troponin. Measuring the levels of these chemicals, often called cardiac biomarkers we can detect a heart attack and provide an indication of how much muscle has been damaged. These cardiac biomarkers are also used in the diagnosis, evaluation, and monitoring of patients with suspected acute coronary syndrome.
Other non-laboratory tests may be performed to assess the effect of a heart attack on the function of the heart, they include a nuclear scan and coronary angiography.
