Heart attack is a medical emergency and if you suspect symptoms of heart attack, you should call for an ambulance or seek immediate medical help.
The following tests may be conducted in the emergency department or at the hospital.
Blood Tests
Routine blood tests may be done for blood counts, electrolytes, cholesterol and cardiac enzymes. The cardiac enzymes in blood are markers of heart damage
Electrocardiogram (ECG)
ECG is a test to measure the electrical activity of the heart and provides your doctor with information about your heart rate, rhythm, size of the heart chambers and previous damage to the heart. It is non-invasive and painless and is performed by attaching electrodes to various parts of the body.
Exercise Tolerance Test (Stress ECG or Exercise Stress Test)
A stress ECG is basically an ECG that is performed while the patient is exercising on a treadmill or a stationary bike. It allows your doctor to see how your heart functions under stress and tells him how healthy your heart is.
Echocardiogram
Echocardiogram uses sound waves to create a moving picture of the heart. The picture is much more detailed than x-ray images and involves no radiation exposure. These ultrasound images help identify abnormalities in the heart muscle and valves, cardiac chambers, and find any fluid that may surround the heart.
Holter Monitor (24 hour ECG monitoring)
This is an ambulatory device that is worn by the patient and records electrical activity of the heart over a 24-hour period. The patient keeps a diary of activities and symptoms for the doctor to compare against the test results.
24 Hour ambulatory blood pressure recording
This is an ambulatory device which allows monitoring the blood pressure over a period of 24 hours. It is useful to compare day time and night time blood pressure and confirms or refute good blood pressure control.
Stress Echocardiogram
A stress echocardiogram allows your doctor a more visual view of your heart. An echocardiogram creates still and moving pictures of your heart at rest by bouncing sound waves off the heart from a device called a transducer. The waves are then used to create a picture of your heart. During a stress echocardiogram, your doctor will perform an echocardiogram while you are resting and then again after you have exercised on a treadmill or stationary bike. The information allows the doctor to learn more about the muscles, valves and other structures of the heart.
CT Coronary Calcium score and CT coronary angiogram
This is carried out using a CT scan to assess the degree of calcium in the wall of the coronary arteries. This is a marker for how much the arteries are furred up and can be used to risk assess. CT scanning can also show the patency of the coronary arteries non-invasively in suitable patients.
Coronary Angiography (Cardiac Catheterisation)
Angiography is an invasive test that enables your doctor to take x-ray images of the inside of your blood vessels. This procedure is performed by a cardiologist and involves threading a tiny catheter through a small incision into a large artery, usually in your wrist and occasionally the groin. Once the catheter reaches the site of the blood vessel to be viewed, a dye is injected and x-ray images are taken. Angiography enables your doctor to view how blood circulates in the vessels in specific areas of the heart.
Cardioversion
Cardioversion is the medical term for restoring an abnormal heart rhythm to normal regular heart rhythm (Sinus rhythm). When the heart rhythm is abnormal, the heart beat less efficiently causing shortness of breath, fatigue and leg swelling. Attempts to restore normal heart rhythm can be done either using medication or external electrical energy. Electric shock energy is applied to the chest for a split second under heavy sedation or general anaesthetic is very effective and is one of the safest way to restore normal heart rhythm. Patient is usually treated with a blood thinning medicine to prevent strokes.