diagnosis and investigations
Last reviewed 12/2020
The criteria for diagnosing myocardial infarction are detection of rise and/or fall of cardiac biomarkers (preferably troponin) with at least one value above the 99th percentile of the upper reference limit, together with evidence of myocardial ischaemia with at least one of the following (1)
- symptoms of ischaemia
- electrocardiogram (ECG) changes indicative of new ischaemia (new ST-T changes or new left bundle branch block (LBBB))
- development of pathological Q wave changes in the ECG
- imaging evidence of new loss of viable myocardium or new regional wall motion abnormality
Notes:
- a chest radiograph may:
- show heart failure
- help to exclude aortic dissection
- laboratory investigations should include:
- urea and electrolytes
- full blood count
- ESR
- cardiac biomarkers (cardiac enzymes)
Reference:
ECG changes in myocardial infarction
echocardiography in myocardial infarction
cholesterol measurement following myocardial infarction
troponin I and troponin T (cardiac enzymes)
assessment in hospital in patients with acute coronary syndrome