Heart Attack Diagnosis

A heart attack diagnosis is based on a person's risk factor assessment, physical examination, laboratory tests, and other medical tests. In life-threatening situations, emergency treatment is started before the diagnosis is finalized.

Risk factor assessment

A heart attack risk factor assessment is based on person's medical history and the medical history of their family members. A doctor or other healthcare provider gathers information by asking specific questions. A questionnaire is often used to help organize the information.

• The medical history contains information about a person's:
  • Health (high blood pressure, diabetes, previously diagnosed heart disease condition, thyroid condition)
  • Lifestyle (physical activity, smoking, alcohol use)
  • Drug use (prescription and over-the-counter medications, supplements, herbs, illegal drugs)
• The family medical history contains information about health problems of family members.
  

Physical examination

The physical examination helps identify any heart attack symptoms. In addition to measuring a person's blood pressure and pulse, the doctor:

• Listens to the chest for abnormal heart and lung sounds.
• Examines the person's eyes, arms and legs, and skin.

Laboratory tests

Laboratory tests are ordered based on a person's risk factor assessment and physical examination. The tests check for test results that fall outside of the normal ranges. Laboratory tests for heart attack include:

• BNP (brain natriuretic peptide, which is a cardiac biomarker)
• Cardiac enzymes (checks creatine kinase, myoglobin, and troponin)
• C-reactive protein test (blood protein that is a sign of inflammation)
• Fasting glucose test (checks blood sugar level)
• Fibrinogen (blood coagulation protein)
• Homocysteine (amino acid increases blood clotting)
• Lipoprotein profile (checks cholesterol and triglyceride levels)
• Prothrombin (blood plasma protein)
  

Medical tests

Additional medical tests help:

• Identify the presence of a person's heart attack risk factors.
• Rule out other diseases.
• Identify the presence and severity of a heart attack.
• Determine a person's treatment options.

A heart attack is a medical emergency. People with heart attack symptoms need to seek emergency medical care. The following tests are often performed in the hospital.

• Chest CT scan
  A chest CT scan (computed tomography scan) uses X-rays to produce cross-sectional computerized images of the heart and lungs. The CT scan identifies an enlarged heart, fluid in the lungs, and lung disease.
• Coronary angiography with cardiac catheterization
  Coronary angiography uses X-rays to examine the coronary arteries after a radiopaque substance is injected into a coronary artery using cardiac catheterization. Cardiac catheterization passes a thin, flexible tube through a coronary artery or into the heart's chambers.
• Echocardiogram
  An echocardiogram uses sound waves (ultrasound) to create moving images of the heart. The test identifies blood flow, heart contractions, and muscle damage.
• Electrocardiogram (ECG, EKG)
  An ECG measures the heartbeat's rate and regularity.
• Magnetic resonance angiography (MRA)
  MRA uses magnetic fields and radio waves to produce images of the blood vessels in the heart. This test doesn't require cardiac catheterization.
• Magnetic resonance imaging (MRI)
  MRI uses strong magnetic fields, radio waves, and a computer to create images of the structure of the heart without radiation or surgery.
  
• Nuclear heart scan
  A radioactive tracer is injected into a person's bloodstream, and then pictures are taken of the heart's blood flow.