Diagnosis of myocardial infarction

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12 Lead EKG ST Elevation tracing color coded
Ha1
MI with contraction bands very high mag
Gross pathology of a one week old myocardial infarction with focal rupture
Gross pathology of old myocardial infarction
Histopathology of myofiber waviness in myocardial infarction

Diagnosis of myocardial infarction

The diagnosis of myocardial infarction (MI), commonly known as a heart attack, involves a combination of clinical evaluation, electrocardiogram (ECG) findings, and biomarker measurements. Myocardial infarction occurs when blood flow to a part of the heart is blocked for a long enough time that part of the heart muscle is damaged or dies.

Clinical Evaluation[edit | edit source]

The clinical evaluation begins with a thorough medical history and physical examination. Patients often present with chest pain or discomfort, which may radiate to the shoulder, arm, back, neck, or jaw. Other symptoms can include shortness of breath, nausea, vomiting, sweating, and lightheadedness.

Electrocardiogram (ECG)[edit | edit source]

An electrocardiogram is a critical tool in the diagnosis of myocardial infarction. It records the electrical activity of the heart and can show abnormalities that indicate an MI. The presence of ST-segment elevation, T-wave inversion, or pathological Q waves on the ECG can suggest myocardial infarction.

Biomarkers[edit | edit source]

Measurement of cardiac biomarkers in the blood is essential for confirming the diagnosis. The most commonly used biomarkers are troponin I and T, which are proteins released when the heart muscle is damaged. Elevated levels of these biomarkers are indicative of myocardial infarction. Other biomarkers that may be measured include creatine kinase-MB (CK-MB) and myoglobin.

Imaging[edit | edit source]

In some cases, additional imaging studies such as echocardiography, cardiac MRI, or coronary angiography may be used to assess the extent of heart damage and to identify blockages in the coronary arteries.

Differential Diagnosis[edit | edit source]

It is important to differentiate myocardial infarction from other conditions that can cause similar symptoms, such as angina, pericarditis, pulmonary embolism, and aortic dissection.

Related Pages[edit | edit source]

References[edit | edit source]

External Links[edit | edit source]


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Contributors: Prab R. Tumpati, MD