What is included in the diagnostic workup for acute coronary syndrome (ACS)?

Updated: Sep 30, 2020
  • Author: David L Coven, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Answer

In the emergency setting, electrocardiography (ECG) is the most important diagnostic test for angina. ECG changes that may be seen during anginal episodes include the following:

  • Transient ST-segment elevations

  • Dynamic T-wave changes: Inversions, normalizations, or hyperacute changes

  • ST depressions: These may be junctional, downsloping, or horizontal

Laboratory studies that may be helpful include the following:

  • Creatine kinase isoenzyme MB (CK-MB) levels

  • Cardiac troponin levels

  • Myoglobin levels

  • Complete blood count

  • Basic metabolic panel

Diagnostic imaging modalities that may be useful include the following:

  • Chest radiography

  • Echocardiography

  • Myocardial perfusion imaging

  • Cardiac angiography

  • Computed tomography, including CT coronary angiography and CT coronary artery calcium scoring

See Workup for more detail.


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