Blood tests provide an indication of heart muscle damage. When some of the heart muscle dies, the dead cells release chemicals into the blood. One chemical that is routinely evaluated is creatinine phosphokinase (CPK), specifically the MB isoform. Another set of chemicals belongs to the troponin family of proteins (troponin I and troponin T). All of these chemicals have high specificity for heart muscle and when they are significantly elevated, confirm a heart attack diagnosis. The CPK MB and troponins provide important information about the extent and severity of your heart attack, when your heart attack might have occurred, and your prognosis.
Heart Attack Medicines
If ECG results determine that you are having a heart attack, your doctor will use medications to help the heart. Several of these drugs are specifically designed to prevent further blood vessel obstruction (aspirin, heparin, low-molecular weight heparin, glycoproteins 2b/3a inhibitors, and clopidogrel). Others, such as oxygen and beta-blockers, improve oxygen utilization by the heart and decrease the heart's workload. Nitrogylcerin and morphine are used to decrease chest pain and reduce heart strain. If you have an arrhythmia during the course of your heart attack, you may also be placed on an antiarrhythmic (other than beta blockers which are, by themselves, effective antiarrhythmics). Diuretics such as Lasix (furosemide) may be prescribed if you have fluid accumulation in your lungs. Cholesterol-lowering agents such as statins and antihypertensive, anti-remodeling agents such as angiotensin-converting enzyme inhibitors (ACE inhibitors) are important adjunctive therapies that may also be used early in the course of your therapy.
If your doctor finds convincing evidence that you are having a heart attack you will be prescribed some form of reperfusion therapy. Reperfusion therapy refers to using intravenous medication (thrombolytic), a percutaneous catheterization-based technique (angioplasty), or surgery to reestablish blood flow to an occluded artery. The decision to receive one of these therapies is dependent upon a number of important factors including how long ago your heart attack started, the severity and instability of your heart attack, and the available resources and experience of the cardiovascular specialists at the hospital at which you are being treated. Each of these therapies has their own unique advantages and disadvantages that will be discussed with you during the very initial phases in the emergency room. If the emergency team has decided during your en route trip to the hospital that you will receive a thrombolytic, you may be started on such medication in the ambulance. Along with reperfusion therapy, heparin and/or 2b/3a inhibitors may be prescribed to reduce the clotting tendency of your blood.
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