Cardiac Emergency

Heart Attack — Symptoms, Blood Tests & What Happens

Recognising a heart attack, the blood tests that confirm it, and how modern treatment works.

Blood test confirms in
3–6 hours (troponin)
Blocked artery
Coronary artery
Types
STEMI & NSTEMI

What Is a Heart Attack?

A heart attack (myocardial infarction) occurs when a coronary artery is suddenly blocked — usually by a ruptured atherosclerotic plaque — cutting off blood supply to part of the heart muscle. Every minute without blood flow causes more permanent damage.

Call 999/911 Immediately If You Have:Chest pain or pressure lasting more than 15 minutes | Pain spreading to arm, jaw, neck or back | Shortness of breath | Nausea, cold sweats or dizziness with chest discomfort.

Types of Heart Attack

TypeECG FindingTreatment Priority
STEMIST elevation — full blockageEmergency angioplasty (PCI) within 90 minutes
NSTEMINo ST elevation — partial blockageUrgent but slightly more time — medications first, then PCI
Unstable anginaNo troponin riseUrgent investigation and treatment — high risk

Blood Tests Used to Diagnose Heart Attack

TestTimingPurpose
Troponin I or T (high-sensitivity)0 hr and 3 hr (or 0 and 1 hr for hs-Troponin)Gold standard — confirms muscle damage
ECGImmediatelyIdentifies STEMI — guides urgency
Full Blood CountOn arrivalAnaemia, platelet count
BNPAt presentationHeart failure severity
Kidney functionOn arrivalBaseline before contrast dye for angiogram
Glucose + HbA1cOn arrivalDiabetes assessment
Lipid profileWithin 24 hoursStatin prescribing decision

FAQs

Can a heart attack happen with no chest pain?
Yes — especially in women, diabetics and older adults. Back pain, jaw pain, breathlessness, fatigue or nausea can be the only symptoms. These are 'silent' heart attacks.
How long does troponin stay elevated?
Troponin peaks at 12–24 hours and stays elevated for 7–14 days — useful for diagnosing recent heart attacks.
What is a normal troponin?
Laboratory-dependent. High-sensitivity troponin normal is typically below 14–52 ng/L depending on the assay. A rise and fall pattern confirms acute injury.
Medical Disclaimer: Heart attack is a life-threatening emergency requiring immediate medical treatment. Do not delay calling emergency services.