Symptoms

The warning signs and symptoms of a heart attack can include:

• Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts for more than a few minutes or goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain. Heart attack pain can sometimes feel like indigestion or heartburn.
• Discomfort in other areas of the upper body. Pain, discomfort, or numbness can occur in one or both arms, the back, neck, jaw, or stomach.
• Shortness of breath. Difficulty in breathing often comes along with chest discomfort, but it may occur before chest discomfort.
• Other symptoms. Examples include breaking out in a cold sweat, having nausea and vomiting, or feeling light-headed or dizzy.

Signs and symptoms vary from person to person. In fact, if you have a second heart attack, your symptoms may not be the same as for the first heart attack. Some people have no symptoms. This is called a "silent" heart attack.

The symptoms of angina (chest pain) can be similar to the symptoms of a heart attack. If you have angina and notice a change or a worsening of your symptoms, talk with your doctor right away.

Diagnosis

Diagnosis of a heart attack may include the following tests:

• EKG (electrocardiogram). This test is used to measure the rate and regularity of your heartbeat. A 12-lead EKG is used in diagnosing a heart attack.
• Blood tests. When cells in the heart die, they release enzymes into the blood. These enzymes are called markers or biomarkers. Measuring the amount of these markers in the blood can show how much damage was done to your heart. These tests are often repeated at intervals to check for changes. The specific blood tests are:
  • Troponin test. This test checks the troponin levels in the blood. This blood test is considered the most accurate to see if a heart attack has occurred and how much damage it did to the heart.
  • CK or CK-MB test. These tests check for the amount of the different forms of creatine kinase in the blood.
  • Myoglobin test. This test checks for the presence of myoglobin in the blood. Myoglobin is released when the heart or other muscle is injured.
• Nuclear heart scan. This test uses radioactive tracers (technetium or thallium) to outline heart chambers and major blood vessels leading to and from the heart. A nuclear heart scan shows any damage to your heart muscle.
• Cardiac catheterization. A thin, flexible tube (catheter) is passed through an artery in the groin (upper thigh) or arm to reach the coronary arteries. Your doctor can use the catheter to determine pressure and blood flow in the heart's chambers, collect blood samples from the heart, and examine the arteries of the heart by x ray.
• Coronary angiography. This test is usually performed along with cardiac catheterization. A dye that can be seen by using x ray is injected through the catheter into the coronary arteries. Your doctor can see the flow of blood through the heart and see where there are blockages.