The veterinarian will need the cat's complete health history, which will include any history of heart disease, a detailed list of symptoms and an approximate date and time when the symptoms first began. The veterinarian will then physically examine the cat, listening to its heart and breathing with a stethoscope, taking its pulse and blood pressure and looking for gait abnormalities that could signal a blood clot. The veterinarian will pay close attention for any signs of heart murmurs or muffled heart sounds that are indicative of fluid in the pericardium, which is the sac that surrounds the heart muscle.
A biochemical profile, complete blood count, and a urinalysis will be done. These labs can help the veterinarian identify systemic conditions that could have caused the heart attack or help the veterinarian rule out other conditions that have similar cardiac symptoms, such as hyperthyroidism. These lab tests may show a high white blood cell count as a result of an infection or high liver enzymes that are indicative of a liver problem.
An electrocardiogram (EKG) and an echocardiogram (ECG) will be performed on the cat. An EKG looks at the heart's electrical activity and can help identify blockages and abnormal heart rhythms. An ECG is an ultrasound of the heart muscle. The ECG will look for abnormalities of the heart valves, the pericardium, and any heart muscle diseases. The veterinarian may also take a chest X-ray of the cat in order to view any abnormalities in the lung cavity.
If the hospital tests are inconclusive as to the condition that caused the heart attack to occur, the veterinarian may want the cat's heart rate monitored for a longer period of time. In this case, the cat may be fitted for a Holter monitor, which will record all heart activity for a 24 hour period, or an event monitor, which will record the heart activity during events such as collapsing.