One person’s heart attack can be very different from another’s. Experts now define six different types of heart attack, reports the February 2013 Harvard Heart Letter. Identifying the cause of an attack helps determine the best way to treat it.
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"