How is a heart attack diagnosed?

The initial diagnosis of a heart attack is made by a combination of clinical symptoms and characteristic electrocardiogram (ECG) changes. An EKG is a recording of the electrical activity of the heart. However, confirmation of a heart attack can only be made hours later through detection of elevated creatinine phosphokinase (CPK) in the blood. CPK is a muscle protein enzyme which is released into the blood circulation by dying heart muscles when their surrounding membranes dissolve.

What is the early management of a patient of heart attack?
Most of the patients of a heart attack are managed in a dedicated heart care unit. Following are the elements in the management:

* Bed rest
* Oral Aspirin
* High flow O2
* Intravenous analgesia with morphine
* Monitoring the E.C.G.

Reperfusion: The immediate goal of treatment is to quickly open blocked arteries and restore blood flow to the heart muscles; a process called “reperfusion.” Early reperfusion minimizes the extent of heart muscle damage and preserves the pumping function of the heart. Many drugs are available to dissolve the clots and restore blood supply. Drugs like tissue plasminogen-activator (t-PA) and streptokinase given intravenously can open 80% of the blocked arteries within 90 minutes.

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