Heart Attack-Tests & Diagnostics

A heart attack is a medical emergency.
Tests to look at your heart include:

  1. Coronary angiography
  2. CT scan
  3. Echocardiography
  4. Electrocardiogram (ECG) — once or repeated over several hours
  5. MRI
  6. Nuclear ventriculography

Blood tests can help show if you have substances produced by heart tissue damage or a high risk for heart attack. These tests include:

  • Troponin I and troponin T
  • CPK and CPK-MB
  • Serum myoglobin

Treatments

If you had a heart attack, you will need to stay in the hospital, possibly in the intensive care unit (ICU). You will be hooked up to an ECG machine, so the health care team can look at how your heart is beating.
Life-threatening irregular heartbeats (arrhythmias) are the leading cause of death in the first few hours of a heart attack. These arrythmias may be treated with medications or electrical cardioverson/defibrillation.

ANGIOPLASTY AND STENT PLACEMENT
Angioplasty, also called percutaneous coronary intervention (PCI), is the preferred emergency procedure for opening the arteries for some types of heart attacks. It should preferably be performed within 90 minutes of arriving at the hospital and no later than 12 hours after a heart attack.
Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart.
A coronary artery stent is a small, metal mesh tube that opens up (expands) inside a coronary artery. A stent is often placed after angioplasty. It helps prevent the artery from closing up again. A drug eluting stent has medicine in it that helps prevent the artery from closing.

THROMBOLYTIC THERAPY (CLOT-BUSTING DRUGS)
Depending on the results of the ECG, certain patients may be given drugs to break up the clot. It is best if these drugs are given within 3 hours of when the patient first felt the chest pain. This is called thrombolytic therapy. The medicine is first given through an IV. Blood thinners taken by mouth may be prescribed later to prevent clots from forming.

OTHER MEDICINES FOR HEART ATTACKS
Many different medicines are used to treat and prevent heart attacks.Nitroglycerin helps reduce chest pain. You may also receive strong medicines to relieve pain. Antiplatelet medicines help prevent clots from forming. Aspirin is an antiplatelet drug. Another one is clopidogrel (Plavix).

Other medications you may receive during or after a heart attack include:

  • Beta-blockers (such as metoprolol, atenolol, and propranolol) help reduce the strain on the heart and lower blood pressure.
  • ACE inhibitors (such as ramipril, lisinopril, enalapril, or captopril) are used to prevent heart failure and lower blood pressure.
  • Lipid-lowering medications, especially statins (such as lovastatin,pravastatin, simvastatin, atorvastatin, and rosuvastatin) reduce blood cholesterol levels to prevent plaque from increasing. They may reduce the risk of another heart attack or death.

CORONARY ARTERY BYPASS SURGERY
Coronary angiography may reveal severe coronary artery disease in many vessels, or a narrowing of the left main coronary artery (the vessel supplying most of the blood to the heart). In these circumstances, the cardiologist may recommend emergency coronary artery bypass surgery (CABG). This procedure is also called “open heart surgery.” The surgeon takes either a vein or artery from another location in your body and uses it to bypass the blocked coronary artery.

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