A Better Test For Heart Attacks

By giving existing emergency room equipment a new use, doctors can more accurately test for heart attacks in patients with chest pains, say Tufts doctors.

Boston [12-04-02] -- More than 6 million people each year visit emergency rooms with complaints of chest pains. In many cases, they are admitted for overnight observation because doctors often cannot rule out a heart attack using standard tests. But a new study by Tufts researchers shows that existing ER imaging equipment can be used as a much more effective tool for detecting heart attacks, greatly reducing the number of unnecessary hospital stays.

“We’re just taking available technology and using it in a new way,” Tufts’ Dr. James Udelson told the Associated Press.

According to the study – which was published in the Journal of the American Medical Association – nuclear imaging technology, typically used in routine stress tests, can be used by ER doctors to quickly evaluate blood flow in the heart.

“In the technique, called myocardial perfusion imaging, a small amount of radioactive tracer is injected into the body,” reported Reuters. “A special camera then detects radiation released by the substance to produce a computer image of the heart muscle, helping doctors determine if the heart is receiving adequate blood flow.”

The new approach, says the associate professor at Tufts School of Medicine, can help doctors quickly determine whether patients are actually having a heart attack or just experiencing similar symptoms.

“By incorporating this information, the emergency room physician can make a decision about who should be in the hospital and who should go home,” Udelson – the associate chief of cardiology at Tufts-New England Medical Center and lead author – told the HealthScout online news service.

In already-crowded emergency rooms, the improved technique will likely have a major impact.

“Many patients with chest pains are unnecessarily admitted to the hospital because of uncertainty about their diagnosis,” Udelson told reporters. “Our findings suggest that nearly 250,000 Americans could be spared the risks and costs of unnecessary hospitalization and more invasive cardiac testing each year by simply adding … the imaging test to the diagnostic protocol for chest pain.”

In the Tufts study, doctors who used the imaging tests reduced unnecessary hospital stays by 20 percent, reported Reuters. The test did not prevent those who needed hospitalization from getting it.

Estimates based on Udelson’s study of more than 2,400 patients, show that up to half of those admitted for hospital stays didn’t need them, costing billions in unneeded treatment.

“The situation goes beyond cost-benefit analysis,” Udelson told HealthScout. “Even a few beds taken up by people who don’t need them can compound a problem. Emergency rooms are increasingly crowded, hospitals are crowded. If a patient doesn’t need a hospital bed, wouldn’t it be nice to find that out faster?”

The findings were widely reported around the world, as newspapers and television stations from New York and Washington to London and India covered the release of the Tufts study.

Photo courtesy ABC News