Because heart attack symptoms can differ from person to person, diagnosing one requires the combination of a doctor's judgment, signs and symptoms, and test results, such as changes in the heart's electrical activity seen on an electrocardiogram. Experts now also advise using a blood test for troponin, a protein released by damaged heart muscle cells.
The latest guidelines for diagnosing a heart attack call for a troponin level that is substantially higher than normal, plus one or more of the following:
- One or more heart attack symptoms, such as chest pain; sudden heaviness, weakness, or aching in one or both arms; sudden shortness of breath; and others
- Worrisome changes on an electrocardiogram or imaging test
- Identification of a clot in a coronary artery
Defining heart attack categories and spelling out clear guidelines for diagnosis will pay off for people struck by a heart attack. "We are laying the groundwork for heart attack care to be standardized. This will allow you to get the same state-of-the-art treatment at your local hospital or at a hospital anywhere in the world as you will at a Harvard-affiliated hospital," says Dr. James Januzzi, Jr., a cardiologist at Harvard-affiliated Massachusetts General Hospital and a member of the task force that updated the definition for heart attack.
Read the full-length article: "Our concept of heart attack is changing"
Also in the February 2013 issue of the Harvard Heart Letter:
- Reducing inflammation may cut heart-attack risk
- Aortic aneurysm: Dealing with a potential killer
- How sleep problems can affect the heart
- Silent heart attacks
The Harvard Heart Letter is available from Harvard Health Publications, the publishing division of Harvard Medical School, for $20 per year. Subscribe at www.health.harvard.edu/heart or by calling877-649-9457 (toll-free).
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