Final answer:
A normal ECG with elevated cardiac enzymes could suggest a non-ST-elevation myocardial infarction (non-STEMI), and further diagnostic tests like echocardiogram, MRI, coronary angiogram, or CTA should be conducted to assess cardiac damage and guide treatment.
Step-by-step explanation:
If a patient has a normal ECG but elevated cardiac enzymes, the differential diagnosis may include but is not limited to a form of myocardial infarction (MI) known as a non-ST-elevation myocardial infarction (non-STEMI). In cases of MI, an ECG may not always show alterations in the ST or Q components. Therefore, despite a normal ECG, elevated levels of cardiac enzymes such as creatine kinase MB (CK-MB) and cardiac troponin suggest myocardial damage and are critical in the diagnosis.
For further workup, additional diagnostic tests should be considered. These tests include an echocardiogram or cardiac magnetic resonance imaging (MRI) to evaluate the structure and function of the heart. Further, a coronary angiogram or computed tomographic angiography (CTA) can be used to visualize the coronary arteries. The presence of risk factors such as high blood pressure, smoking, and diabetes can also support the diagnosis. All these can help determine the extent of cardiac damage and guide treatment strategies.