Diagnosis of myocardial infarction

Myocardial infarction diagnosis
PurposeDiagnose myocardial infarct via physical exam and EKG (plus blood test)

A diagnosis of myocardial infarction is created by integrating the history of the presenting illness and physical examination with electrocardiogram findings and cardiac markers (blood tests for heart muscle cell damage).[1][2] A coronary angiogram allows visualization of narrowings or obstructions on the heart vessels, and therapeutic measures can follow immediately. At autopsy, a pathologist can diagnose a myocardial infarction based on anatomopathological findings.

A chest radiograph and routine blood tests may indicate complications or precipitating causes and are often performed upon arrival to an emergency department. New regional wall motion abnormalities on an echocardiogram are also suggestive of a myocardial infarction. Echo may be performed in equivocal cases by the on-call cardiologist.[3] In stable patients whose symptoms have resolved by the time of evaluation, Technetium (99mTc) sestamibi (i.e. a "MIBI scan"), thallium-201 chloride or Rubidium-82 Chloride can be used in nuclear medicine to visualize areas of reduced blood flow in conjunction with physiologic or pharmacologic stress.[3][4] Thallium may also be used to determine viability of tissue, distinguishing whether non-functional myocardium is actually dead or merely in a state of hibernation or of being stunned.[5]

  1. ^ Mallinson T (2010). "Myocardial Infarction". Focus on First Aid (15): 15. Archived from the original on 2010-05-21. Retrieved 2010-06-08.
  2. ^ "Myocardial infarction: diagnosis and investigations". GPnotebook. Retrieved 27 November 2006.
  3. ^ a b Fenton DE, Stahmer S, Baumann DM. McNamara RM, Talavera F, Halamka J, Feied C (eds.). "Myocardial infarction]". eMedicine. Archived from the original on 25 December 2006. Retrieved 27 November 2006.
  4. ^ "HEART SCAN". University College London. Archived from the original on 16 February 2009. Retrieved 27 November 2006.
  5. ^ Skoufis E, McGhie AI (1998). "Radionuclide techniques for the assessment of myocardial viability". Texas Heart Institute Journal. 25 (4): 272–279. PMC 325572. PMID 9885104.