Signs Of A Heart Attack: Hospital Detection Methods

Heart attacks are medical emergencies, and knowing the signs and acting quickly can increase your chances of survival and recovery. If you suspect a heart attack, you should call 911 immediately. The first test to diagnose a heart attack is typically an electrocardiogram (ECG or EKG), which can be performed in an ambulance on the way to the hospital. An ECG is a simple, painless test that records the heart's electrical activity through small electrodes placed on the chest, arms, and legs. Upon arrival at the hospital, a physical examination and a series of tests, including blood tests, imaging tests, and stress tests, are performed to diagnose and grade the severity of a heart attack.

Electrocardiogram (ECG)

An electrocardiogram (ECG or EKG) is a test that measures the electrical activity of the heartbeat. It is a tool for diagnosing heart issues and can be used to check a patient's heart rhythm after a heart attack.

Every time the heart beats, it produces tiny electrical impulses. An ECG machine records these signals, allowing doctors to see how well the heart is functioning. Small stickers (electrodes) are attached to the patient's arms, legs, and chest, and wires from these electrodes are connected to the ECG machine, which records the electrical impulses. The test is painless and takes about 5 minutes.

The machine creates a wave pattern that a healthcare provider can interpret. A normal heartbeat on an ECG will show the rate and rhythm of the contractions in the upper and lower chambers. Unusual wave patterns can indicate a problem, and abnormal ECG results can help providers identify which part of the heart is affected.

ECGs are typically conducted in a medical facility, and the test only tracks the heart's electrical activity for a short time (usually around 10 seconds). Therefore, it may not detect issues that only occur occasionally. Other tests may be required to confirm a diagnosis.

Blood tests

When the heart is damaged or stressed, certain proteins, known as cardiac markers or cardiac biomarkers, leak into the blood. These biomarkers are measurable indicators of heart function and can confirm a heart attack based on the level and timing of their elevation in the blood. One of the most common blood tests for detecting heart muscle damage is the troponin test, which is generally sensitive enough to detect damage about 12 hours after a cardiac event. Doctors may also use repeated blood tests to monitor changes in biomarker levels over time.

In addition to the troponin test, other blood tests can be used to assess the risk of a future heart attack. For example, an exercise stress test can reveal how the heart responds to the increased blood flow demands of physical activity. During this test, the patient walks on a treadmill at progressively faster speeds while trained staff monitor their heart's electrical activity, heart rate, and blood pressure. An imaging test, such as an echocardiogram or nuclear perfusion test, may also be performed in conjunction with the exercise stress test to further evaluate blood flow to the heart.

Imaging tests

Hospitals use imaging tests to check for heart attacks. These tests help doctors check whether a patient's heart is working properly and determine the amount of damage to the heart. Imaging tests for heart attacks include chest X-rays, computed tomography (CT) scans, echocardiograms, nuclear stress tests, and cardiac magnetic resonance imaging (MRI).

Chest X-rays are useful when the diagnosis of a heart attack is uncertain and there are other possible causes of symptoms, such as a pneumothorax or pulmonary oedema. X-rays can also be used to check for complications that may have occurred due to a heart attack, such as a build-up of fluid in the lungs.

Computed tomography (CT) scans combine X-rays and computer technology to create detailed, cross-sectional views of the heart and its arteries. CT scans can measure a patient's coronary artery calcium (CAC) score and check for significant blockages in the heart arteries.

Echocardiograms, also called transthoracic echocardiograms (TTE), use sound waves to create moving pictures of the heart's chambers, valves, and walls. They can be used to assess the heart's function and structure, detect fluid buildup, and diagnose conditions such as blood clots in the lung.

Nuclear stress tests use a radioactive tracer to show blood flow in and around the heart. The tracer is injected into the bloodstream, and a special camera is used to take pictures of the heart. This test is performed once when the patient is resting and once after exercising.

Cardiac magnetic resonance imaging (MRI) uses powerful magnets and radio waves to create precise still and moving images of the heart and surrounding blood vessels. MRI provides excellent views of the heart's size and structure and can reveal evidence of scarring from previous heart attacks, active inflammation, valve disorders, and enlarged arteries.

Exercise stress test

An exercise stress test, also called a cardiac stress test, treadmill stress test, or simply a stress test, is a method for evaluating heart function and blood flow. It involves exercising or taking medications that simulate the effects of exercise.

There are different types of exercise stress tests, including the stress echocardiogram and nuclear stress test. In the classic exercise stress test, you walk on a treadmill that makes your heart work progressively harder. An electrocardiogram (ECG) monitors your heart's electrical rhythms. An ECG is also used to measure the electrical activity of your heart when you are admitted to the hospital with a suspected heart attack. This test is painless and takes about 5 minutes.

Echocardiogram

An echocardiogram, also known as an echo, is a test that uses high-frequency sound waves (ultrasound) to create images of the heart. This test is non-invasive and painless, with no side effects. It allows doctors to examine the heart's internal structure and observe how blood flows through it. This information helps in diagnosing several types of heart problems, including an enlarged heart or thick ventricles (the lower chambers of the heart).

During an echocardiogram, a cardiac sonographer or echocardiographer moves a wand, called a sound-wave transducer, across the patient's chest. The transducer emits sound waves, which create detailed images of the heart. These images can be used to identify a range of heart issues, including partial or complete blockage of a heart artery, the source of a blood vessel blockage, or problems with the mitral valve.

There are several types of echocardiograms:

• Transthoracic echocardiography: Used to check for heart failure and find the cause of a heart murmur.
• Stress echocardiography: Can identify partial or complete blockage of a heart artery.
• Transesophageal echocardiography: Includes finding the source of a blood vessel blockage or prosthetic valve problem.
• 3D echocardiography: Used to diagnose issues with the mitral valve.
• Fetal echocardiography: Used to detect problems in the heart of an unborn baby.

The duration of an echocardiogram can vary, typically ranging from 10 minutes to 2 hours, depending on the specific type of test being performed. After the test, it is recommended to stay for at least half an hour for observation, and in some cases, recovery time may be longer.

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