Troponin

Troponin is a special enzyme of the heart muscle. When heart muscle cells die or are destroyed, they release their ingredients. Typically, troponin T is determined in the blood when a heart attack is suspected.

It can be measured in higher concentrations, especially 3-8 hours after a heart attack. In addition, up to two weeks after the heart attack, it can still be detected in the blood with an elevated value. However, troponin T can also be falsely elevated (if it has nothing to do with a heart attack). This is the case when the kidneys are no longer fully functional because too little troponin is excreted and therefore higher levels are present in the blood. Even if the skeletal muscles are exposed to extreme stress, as is the case with marathon runners, for example, the troponin T value increases.

Echocardiography

Echocardiography, an ultrasound examination of the heart (cardiac echo), is used to examine the shape and form of the heart and to make a functional diagnosis (wall movement disorders of the heart due to tissue loss can be detected). It is a non-invasive examination and can be performed quickly. The echo examination makes it possible to assess the movement of the heart wall, which is of great diagnostic relevance, since disturbances in the movement of the heart wall during contraction of the heart indicate an infarction zone or scar.

In fresh myocardial infarction, wall movement disorders occur even before the increase in heart muscle-specific enzymes. In the absence of such movement disorders, a myocardial infarction can be ruled out with 95% probability.Furthermore, echocardiography allows the determination of the heart size and a possible dilatation of the heart after an infarction, the pumping capacity of the heart and the function of the heart valves. Infarctions mostly affect the left ventricle and their localization can be recognized by the different supply areas of the coronary arteries.

However, due to the interindividual anatomical differences in the course of the coronary vessels (coronaries) and the lack of knowledge about the existing type of cardiac supply (vascular supply to nourish the heart muscle cells), no exact statement can be made about which vessel is occluded. This requires an angiographic examination of the coronary vessels using a catheter and the administration of contrast medium (cardiac catheter). General information about ultrasound can be found under our topic: Ultrasound