Treatment & Diagnosis
If you have had a heart attack, the following tests and procedures may be performed:
Electrocardiogram (ECG). This test to show the electrical conduction of the heart will be one of the first used to diagnose a heart attack. During a heart attack, the heart muscle is injured and it won't conduct electricity normally. This will be shown on the ECG. Initial blood tests may be done to determine if there has been damage to your heart. If damage to the heart muscle has occurred, enzymes slowly leak into your blood flow. These enzymes are measured in blood tests called troponin and CK total.
Cardiac Nuclear Scan. This test helps identify blood-flow problems with the heart. By injecting radioactive material through an IV site, physicians will be able to identify areas of the heart that are not allowing blood to flow properly.
Echocardiogram. This test can help identify whether an area of your heart has been damaged by a heart attack. Using sound wave technology, it can provide images of your heart and can detect poor heart wall motion, an indicator of heart damage.
Cardiac Catheterization. This test can help determine whether your coronary arteries are narrowed or blocked. This is done by placing a small catheter into an artery, usually in the groin, which is fed to the arteries of the heart. A liquid dye is then injected to visualize the coronary arteries, thereby revealing areas of blockages (also known as angiography). Additionally, if a blockage is discovered, the area can be treated while the catheter is in place in a procedure called angioplasty.
Percutaneous Cardiac Intervention (PCI). Similar to the cardiac catheterization, this test can actually treat blockage by using balloon angioplasty and/or by placing a stent. Balloon angioplasty is a catheter with a balloon tip that is fed through the arteries to the blockage. The balloon is opened and pushes plaque back against the arterial wall, which allows for improved blood flow. Coronary stenting often accompanies angioplasty. Stents are small wire mesh devices used as scaffolding to support and open the arterial wall, thereby reducing the chance the artery will re-close. PCI usually takes 1-2 hours to complete and is done with local anesthesia. Blood thinners may be used through an IV to prevent clotting. A medication called clopidogrel (Plavix) along with aspirin is usually prescribed for three months (depending on physician practice) to prevent blood clot formation within the affected vessel.
Coronary Artery Bypass Surgery. Of those people who have heart disease, approximately 10% will undergo coronary artery bypass graft surgery (CABG). Those with severe narrowing or blockages, especially involving multiple arteries, may be considered for bypass surgery. This is an operation performed by a surgeon and done under general anesthesia. The surgeon takes a healthy vessel from the leg, chest or arm and creates a bypass around the blockage, restoring blood flow to the heart muscle. Typically, one to five bypasses can be done, depending upon how many coronary arteries are blocked. A CABG procedure usually requires about a five-day stay in the hospital and up to three months to fully recover from the surgery.
Minimally invasive valve surgery. This procedure is an innovative approach to treating heart valve disease. Rather than making a large incision through the breastbone (sternum) to gain access to the heart, this method uses sophisticated instruments to perform the surgery through a smaller incision at the side of the chest. Minimally invasive valve surgery is a highly advanced technique that requires special expertise and equipment. Only select hospitals such as Anderson Regional Heart Center offer this approach. Patients report having significantly less pain, with many patients able to control pain with over-the-counter medications. Some valve problems are treated with the assistance of the da Vinci Surgical System, a sophisticated robotic device.