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Tests, Investigations and medications for heart problems

The following tests may reveal a heart attack and the extent of heart damage:

  • Electrocardiogram (ECG) – usually repeated over several hours
  • Echocardiography
  • Coronary angiography

The following tests may show the by-products of heart damage and factors indicating you have a high risk for heart attack:

  • Troponin I and troponin T
  • CK and CK-MB
  • Serum myoglobin

A heart attack is a medical emergency! Hospitalisation is required and intensive care is usually needed. When admitted, continuous ECG monitoring is started immediately. Life-threatening arrhythmias, (unstable heart rhythms) are the leading cause of death in the first few hours of a heart attack so it's essential patients are closely monitored.


The goals of treatment for heart attacks are to stop its progression by reducing demands on the heart so it can heal, and prevent complications.

Medications and fluids are inserted directly into a vein using an intravenous (IV) line. Various high tech monitoring devices are also used to monitor the hearts status. A urinary catheter is sometimes inserted into a patient's bladder to closely monitor fluid status


Oxygen is usually given, even if blood oxygen levels are normal. This ensures oxygen is readily available for the tissues of the body and assists in reducing the workload on the heart.

Pain Control

Intravenous nitro-glycerine or other similar type medicines are given for pain and to reduce oxygen requirements for the heart. Morphine and similar medicines are very effective pain killers usually prescribed for those suffering a heart attack.

Blood Thinning Medications

Thrombolytic therapy

If the ECG recorded during acute chest pain shows a change called "ST-segment elevation," clot-dissolving (thrombolytic) therapy should be initiated within 6 hours of beginning of chest pain. The initial therapy is administered as an IV infusion of streptokinase or tissue plasminogen activator, and is followed by an IV infusion of heparin. Heparin therapy usually lasts for 48 to 72 hours. Additionally, warfarin taken orally is often prescribed to prevent further development of clots.


Thrombolytic therapy is not appropriate for people who have had:

  • A major surgery, organ biopsy, or major trauma within the past 6 weeks
  • Recent neurosurgery
  • Head trauma within the past month
  • History of GI (gastrointestinal) bleed
  • Brain tumour
  • Stroke within the past 6 months
  • Current severely elevated high blood pressure

Thrombolytic therapy can also be complicated by significant bleeding.

Emergency coronary angioplasty may be required to open blocked coronary arteries. This procedure can be used instead of thrombolytic therapy or in cases where Thrombolytics should not be used. Often the re-opening of the coronary artery after angioplasty is ensured by implantation of a small device called a stent! Emergency coronary artery bypass surgery (CABG) may be required in some cases.

Platelets collecting and accumulating is the initial event often leading to clot formation. So a cornerstone of therapy for a heart attack is antiplatelet medication. This medication can prevent the collection of platelets at the site of injury in a blood vessel wall (like a crack in an atherosclerotic plaque) and is very useful. One antiplatelet agent widely used is the common aspirin! Two other important antiplatelet medications are ticlopidine (Ticlid) and clopidogrel (Plavix).

Other Medications

Beta-blockers (like metoprolol, atenolol, and propranolol) are used to reduce the workload of the heart.

ACE Inhibitors (like ramipril, lisinopril, enalapril, or captopril) are used to prevent heart failure.

Factors affecting heart disease

Include

  • Smoking
  • High Blood Pressure
  • Diet
  • Stress
  • Family History

The following sections deal with various aspects of your life-style which you may need to give greater consideration to. Advice is also offered to substantially reduce the risk of worsening heart disease.

Read each section carefully and seriously consider what changes should apply to you – and think about carrying them out!

>> Effects of smoking on heart disease >>