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A heart attack is a process that spans over several hours and a fast diagnosis can increase the chance of survival and minimize the damages. A heart attack diagnosis involves a physical examination, a medical review of health problems, and diagnostic tests.

Physical examination: During a physical examination the medical team will check the pulse and blood pressure. The heart and lungs will be listen to with a stethoscope and the patient is usually hooked up to a heart monitor.

Medical review of health problems: During the medical health review, the doctor collects information regarding past medical problems such as a history of heart diseases in the family, past heart or blood vessel problems, a review of heart attack risk factors, and present symptoms.

Diagnostic Tests:Diagnostic tests are divided in two categories non invasive tests and invasive tests.

Although symptoms vary with every heart attack, several common signs signal that a heart attack is occurring. Based on symptoms, a few questions and vital sign checks, paramedics or emergency room personnel can usually diagnose a heart attack. After immediate treatment to open the blockage, several diagnostic tests can examine the aftereffects of an attack. Read more about heart attack diagnosis.

Exams and Tests

Diagnosis and treatment tend to occur at the same time in patients who present with chest pain. If there is concern that heart muscle is at risk, delays need to be minimized so that blood supply to that muscle can be restored.

Medical History

As is the case in most of medicine, the diagnosis of angina is made by history. If the story that the patient tells is suggestive of cardiac ischemia (cardiac= heart + ischemia= decreased blood supply), then the care provider will continue on the path to determine whether a heart attack has occurred.

The medical history also includes assessing risk factors for heart disease, including:

1.Family history of heart disease, especially at an early age
2.Previous history of other blood vessel problems like stroke or peripheral vascular disease
3.Diabetes
4.High cholesterol
5.Hypertension or high blood pressure
6.Smoking

Heart Attack Diagnosis Tests:

1.Coronary Angiography
2.Chest Radiographs
3.Nuclear Scan
4.Cardiac Enzymes
5.Blood Tests
6.Electrocardiogram (ECG)

Coronary Angiography (or arteriography):This test is used to check blockages and narrowed areas inside coronary arteries. A fine tube (catheter) is threaded through an artery of an arm or leg up into the heart. A dye that shows up on X ray is then injected into the blood vessel, and the vessels and heart are filmed as the heart pumps. The picture is called an angiogram or arteriogram.

Coronary catheterization (angiogram): This test can show if your coronary arteries are narrowed or blocked. A liquid dye is injected into the arteries of your heart through a long, thin tube (catheter) that’s fed through an artery, usually in your leg, to the arteries in your heart. As the dye fills your arteries, the arteries become visible on X-ray, revealing areas of blockage. Additionally, while the catheter is in position, your doctor may treat the blockage by performing an angioplasty, also known as coronary artery balloon dilation, balloon angioplasty and percutaneous coronary intervention. Angioplasty uses tiny balloons threaded through a blood vessel and into a coronary artery to widen the blocked area. In most cases, a mesh tube (stent) is also placed inside the artery to hold it open more widely and prevent re-narrowing in the future.

Nuclear Scan. This test helps identify blood flow problems to your heart. Small amounts of radioactive material are injected into your bloodstream. Special cameras can detect the radioactive material as it flows through your heart and lungs. Areas of reduced blood flow to the heart muscle — through which less of the radioactive material flows appear as dark spots on the scan.

Chest X-ray: An X-ray image of your chest allows your doctor to check the size and shape of your heart and its blood vessels.

Echocardiogram. This test uses sound waves to produce an image of your heart. During an echocardiogram, sound waves are directed at your heart from a transducer, a wand-like device, held on your chest. The sound waves bounce off your heart and are reflected back through your chest wall and processed electronically to provide video images of your heart. An echocardiogram can help identify whether an area of your heart has been damaged by a heart attack and isn’t pumping normally or at peak capacity.

Cardiac Computerized Tomography (CT) or magnetic resonance imaging (MRI): These tests can be used to diagnose heart problems, including the extent of damage from heart attacks. In a cardiac CT scan, you lie on a table inside a doughnut-shaped machine. An X-ray tube inside the machine rotates around your body and collects images of your heart and chest. In a cardiac MRI, you lie on a table inside a long tube-like machine that produces a magnetic field. The magnetic field aligns atomic particles in some of your cells. When radio waves are broadcast toward these aligned particles, they produce signals that vary according to the type of tissue they are. The signals create images of your heart.

Exercise Stress Test: In the days or weeks following your heart attack, you may also undergo a stress test. Stress tests measure how your heart and blood vessels respond to exertion. You may walk on a treadmill or pedal a stationary bike while attached to an ECG machine. Or you may receive a drug intravenously that stimulates your heart similar to exercise.

Stress tests help doctors decide the best long-term treatment for you. If your doctor also wants to see images of your heart while you’re exercising, he or she may order a nuclear stress test, which is similar to an exercise stress test, but uses an injected dye and special imaging techniques.

Blood Tests:Certain heart enzymes slowly leak out into your blood if your heart has been damaged by a heart attack. Emergency room doctors will take samples of your blood to test for the presence of these enzymes.

Electrocardiogram (ECG):This is the first test done to diagnose a heart attack. It’s often done while you are being asked questions about your symptoms. This test records the electrical activity of your heart via electrodes attached to your skin. Impulses are recorded as “waves” displayed on a monitor or printed on paper. Because injured heart muscle doesn’t conduct electrical impulses normally, the ECG may show that a heart attack has occurred or is in progress.