Diagnostic Exam:

Electrocardiogram (ECG) - a medical test that detects heart problems by

measuring the electrical activity generated by the heart as it contracts. It is a first
test done to diagnose a heart attack records electrical signals as they travel
through the heart. Sticky patches (electrodes) are attached to the chest and
limbs. Signals 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.
 ST Segment Elevation- results from the area of injury (early sign).
 T Wave Inversion- originates from the area of ischemias ( Angina
Pectoris)
 Pathologic Q Wave- developed from the area of infarction (late sign).
Cardiac Enzyme- it studies measure the levels of enzymes and proteins that are
linked with injury of the heart muscle.
 Elevated CK-MB (Creatine-Kinase) - most reliable cardiac specific
enzyme. Myocardial muscle creatine kinase (CK-MB) is found mainly in
the heart. CK-MB levels increase within 3-12 hours of onset of chest pain,
reach peak values within 24 hours, and return to baseline after 48-72
hours.
 Elevated Troponin Levels- most definitive. Troponin is a protein released
from myocytes when irreversible myocardial damage occurs. It is highly
specific to cardiac tissue and accurately diagnoses myocardial infarction
with a history of ischaemic pain or ECG changes reflecting ischemia.
Cardiac troponin level is dependent on infarct size, thus providing an
indicator for the prognosis following an infarction. Cardiac troponins T and
I are highly sensitive and specific for cardiac damage. Troponin I and T
are of equal clinical value. Serum levels increase within 3-12 hours from
the onset of chest pain, peak at 24-48 hours, and return to baseline over
5-14 days. Troponin levels may not be detectable for six hours after the
onset of myocardial cell injury. The most sensitive early marker for
myocardial infarction is myoglobin. Troponin levels should be measured at
presentation and again 10-12 hours after the onset of symptoms. When
there is uncertainty regarding the time of symptom onset, troponin should
be measured at twelve hours after the presentation.
 Elevated Lactate Dehydrogenase (LDH)- increase only with cardiac
damage 3-6 hours after onset of MI. High levels of LDH indicate some
form of tissue damage

Complete Blood Count (CBC)- may show elevated WBC result