B. Blood Tests/Cardiac Enzymes
The results of cardiac enzymes, CK–MB and troponins, are not relevant for the diagnosis of ST segment elevation MI. This diagnosis must be made within the hour by ECG and cannot await the results of cardiac enzymes that become elevated only after 6–12 h from the onset of chest pain. An elevation of troponin levels indicates the presence of micro-infarction, and if the ECG does not show ST elevation, then the diagnosis is clearly non-ST segment elevation MI.
C. Echocardiography
This test is not indicated in all patients admitted to the emergency room. The area of infracted muscle is detected as an area that moves very poorly during sys¬tolic contraction and is described as the presence of left ventricular wall motion abnormalities. An ejection frac¬tion can be obtained and is useful for risk stratification. Echocardiography is useful in patients with complicated

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