Diagnosis

Diagnosis will probably take place in the emergency department of a hospital.

A doctor will check your blood pressure, pulse and temperature. He/she will also listen to your heart and lung sounds using a stethoscope. He/she will take a detailed history of recent events as well as a general medical history.

Your doctor may also want to conduct tests to determine whether you are having a heart attack or whether your symptoms are caused by another condition. These tests may include:

• ECG (electrocardiogram): a simple, painless procedure in which the heart’s electrical impulses are recorded by electrodes attached to your chest and each limb. An ECG can identify abnormalities in your heart rate and rhythm.
  
  
• Blood tests: certain chemicals called enzymes slowly leak out into the blood if the heart has been damaged by a heart attack. Simple blood tests can detect the presence of these enzymes.
  
  
• Chest X-ray: an X-ray image showing the size and shape of your heart and the blood vessels supplying your heart.
  
  
• Nuclear scan: a procedure in which a small, safe amount of radioactive material is injected into your bloodstream. Cameras can detect the radioactive material as it passes through your heart and lungs and any areas of blockage in the arteries are shown on the scan.
  
  
• Echocardiogram: a painless procedure which uses ultrasound (sound waves) to produce an image of your heart and can identify whether a heart attack has caused any damage to your heart. An echocardiogram can also show if your heart isn’t pumping normally.
  
  
• Coronary angiogram: a special X-ray test which will show if your coronary arteries are blocked and if so, by how much. A doctor will insert a long, thin flexible tube called a catheter into an artery in your forearm or groin. The catheter is then guided toward the heart and, once in position, a special dye is injected through the catheter so the arteries show up on the X-ray. This procedure will be carried out in hospital. You may feel some discomfort or may feel unwell during the procedure. Afterwards you will be asked to lie quietly on your back for a few hours.