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Thursday, May 20, 2010

Tests to Diagnose Heart Attack

Posted by Prahallad Panda on 1:36 PM Comments

A coronary angiogram that shows the LMCA, LAD ...Image via Wikipedia
Heart attack is a grave situation requiring urgent attention. Diabetic and hypertensive patients are prone to it. It may present as an acute condition with destruction of musculature of heart called Myocardial Infarcation or in a more insidious way as angina. In myocardial infarction there may be ;
  • sudden fainting attack,
  • sudden fall of blood pressure in hypertensive patients,
  • Severe cold sweating,
  • Pulselessness,
  • Pain in the chest, especially in the left side,
  • Breathlessness,
  • Sudden death.

These clinical features, almost suggest a classical case of heart attack or myocardial infarction. Some quick blood tests are ;
  1. Troponin test; a small amount of blood is taken from the vein of the patient for the test. It does not take much time to get the result. Troponin I level more than 10 micrograms/liter and Troponin T level more than 0.1micrograms/liter are taken as positive for myocardial damage. In heart attack it becomes positive within 6 hours and there is definite rise after 12 hours. It remains elevated for 1 to 2 weeks following it. Though this test is more specific in comparison to other blood tests, still can be false positive in certain diseases like

    • Blood clots in the lungs,
    • Spasm of arteries to heart,
    • Severe gastrointestinal bleeding,
    • Weakening of the heart muscle (cardiomyopathy),
    • Angioplasy/stenting of heart,
    • Viral infection of heart muscle,
    • Strenuous exercise,
    • and
    • Open heart surgery
    • etc.
  2. CPK stands for creatine phosphokinase; a blood test frequently done for the support to the diagnosis. This test has been superseded by the troponin test.
  3. CRP stands fro C-reactive protein, has less supportive value than the above two. 
  4. Copeptin, a new biomarker for heart attack is having promising results, but at present not widely available.
Simultaneously an Electrocardiogram recording can be done. Changes in the electrical activity of heart can be recorded by this machine, which will support the diagnosis. More tests like an echo-cardiogram, functional MRI and angiogram can be planned for future for definitive treatment, in case to case basis.
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