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Understanding Heart Enzymes and their Relationship with Heart Attack

Heart enzymes are enzymes that play a role in supporting the work of the heart muscle. When there is damage, such as a heart attack, then this enzyme will increase in amount in the blood. Therefore, examination of heart enzymes is often done as a way to diagnose a heart attack. When someone complains of chest pain that is suspected of having a heart attack, the doctor will conduct a series of tests, including a heart enzyme test. The increasing amount of heart enzymes found in the blood indicates the greater damage that occurs in the patient's heart.

Get To Know Heart Enzymes

Some types of cardiac enzymes and proteins that are often checked by doctors when someone is suspected of having a heart attack are:

Creatine kinase (creatine kinase / CK)

This enzyme is found in body tissues such as skeletal muscle, and heart and brain organs. An increase in the CK enzyme can indicate the condition of a heart attack. CK levels begin to be detected in the blood within 4-6 hours after the heart muscle is damaged, and will increase to 24 hours after a heart attack. Even so, CK can also increase in several other conditions, such as rhabdomyolysis, infection, kidney damage, and muscular dystrophy.

Troponin

Troponin is a type of protein found in the heart and muscles. There are 3 types of troponin, namely troponin T, C, and I, but those specifically examined together with cardiac enzymes are troponin T and I. Troponin levels can increase within 2-26 hours after heart muscle damage. Apart from a heart attack, troponin levels can also increase when inflammation and damage to the heart muscle occur due to other diseases, such as myocarditis. Therefore, there is now a special troponin examination called high-sensitivity cardiac troponin (hs-cTn). This type of examination can detect heart damage from a heart attack better.

Myoglobin

Is a protein found in skeletal muscle and heart muscle. Myoglobin levels will increase within 2-12 hours after a heart attack, and return to normal levels within 24-36 hours after a heart attack. Because it can increase in other disease conditions, myoglobin levels are often checked together with heart enzymes and other heart tests, such as an EKG to diagnose a heart attack. In practice, the diagnosis of a heart attack is not only based on the results of a heart enzyme examination, but also requires a physical examination by a doctor, plus other supporting tests, such as ECG, angiography, and cardiac catheterization.

Heart Enzyme Examination Procedure

The procedure for examining heart enzymes is quite simple and no special preparation is needed, for example having to fast first or stop taking certain drugs. Only, the doctor will ask some important things ranging from a family history of heart disease or that may be experienced by the patient before, a history of medication consumption, to the symptoms felt by the patient before doing a heart enzyme examination. Basically, this examination is very similar to a blood test, with the following steps:
  • The doctor or medical officer will tie the patient's arm with a tourniquet to slow blood flow and make veins more visible.
  • Medical personnel identify the location of veins, then clean the area to be injected with alcohol.
  • Medics begin to draw blood using syringes.
  • After the blood is drawn and the syringe is pulled out of the vein, the medical staff will put gauze or tape to cover the injection site.

Heart attack treatment

When experiencing heart attack symptoms such as severe chest pain that radiates to the arm or neck, cold sweating, and weakness, the patient needs to immediately seek treatment at the nearest hospital emergency room to get further examination and treatment from a doctor. If the results of a heart enzyme examination confirm the patient has a heart attack, the doctor will provide treatment, such as placing an IV and giving oxygen, blood-thinning drugs, clopidogrel, and drugs to destroy the blockage in the heart's blood vessels. In certain cases, after receiving treatment in the ER the patient will be referred to a cardiologist for cardiac catheterization or heart surgery. After that, patients need to be hospitalized to monitor their condition. During treatment, the doctor will monitor the patient's condition and check the heart's enzymes periodically to assess the condition of the heart. After being discharged, the doctor will also advise the patient to adopt a healthy diet and lifestyle to maintain his heart health and reduce the risk of recurring heart attacks

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