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Once you get medical help, you'll be given tests to see if you've really had a heart attack. If you have, health care providers will then run some tests to figure out what kind of heart attack you've had and how much damage it has done. Some of these tests may be carried out in the ambulance by paramedics.¹ Others will be done in the hospital by doctors.

The most common tests are listed below.

An EKG is one of the most important tests doctors use to figure out whether you've had a heart attack.

You'll probably have several EKGs during your first few days in the hospital.

When you have an EKG, doctors put electrodes on your chest. This lets them measure the electrical activity in your heart.

The electrodes are connected to a machine that shows the electrical activity as a tracing on a moving screen. EKGs don't hurt and don't have any effect on your heart.

From your EKG, your doctors will be able to tell:

• Whether you've had a heart attack
• What kind of heart attack you've had
• Which part of your heart has been damaged
• How fast your heart is beating
• Your heart's rhythm, that is, whether your heart is beating in a regular pattern.

When your heart is damaged, the levels of certain chemicals in your blood go up. Measuring the level of these chemicals helps doctors find out whether you've had a heart attack.

Coronary arteriography is a way for doctors to see whether your coronary arteries have any blockages or narrowed areas. Your coronary arteries supply your heart with blood.

This test is done in an X-ray laboratory. You may hear medical professionals refer to the laboratory as the "cath lab."

If you have arteriography, doctors thread a thin tube (called a catheter) through an artery in your arm or thigh and into your heart. Then they inject dye through the tube into your coronary arteries. When they take the X-ray, the dye shows up on the film. If doctors find that your arteries are very narrow, they may suggest you have an operation to widen them.

You may be given sedatives (drugs that make you feel sleepy) before this test.

An echocardiogram uses sound waves to give doctors an idea of how well your heart is working. This test can help them find out which part of your heart is damaged. They can also see how blood flows through your heart and see if your heart valves are working correctly. A special instrument that sends and receives sound signals is placed on your chest. And the echoes it records are displayed on a screen. An echocardiogram is especially useful for seeing how your heart wall moves as it beats. This test is safe, and it doesn't hurt.

This test can show doctors which areas of your heart have been damaged. Doctors inject a tiny amount of a radioactive substance into your bloodstream, usually through a vein in your arm. A special camera records whether the substance is taken up by your heart.

While you walk on a treadmill, doctors do an electrocardiogram (ECG) to see how well your heart is recovering. It's likely you'll have this test before you leave the hospital. If the test shows that the blood supply to your heart is poor, your doctor may suggest that you have coronary arteriography (which is described above).

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.