study lauds accuracy of new test for heart attacks

When it comes to heart attacks, time is of the essence. The sooner a patient receives an accurate diagnosis and appropriate treatment, the better the outcome is likely to be. That is precisely why when a patient reports to the emergency room complaining of certain symptoms — chest discomfort or pain, sweating, indigestion, shortness of breath, etc. — medical professionals must act quickly and decisively in order to prevent permanent damage to the heart or death.

Specifically, ER physicians must be certain to spend enough time with their patients to understand their symptoms and order the appropriate tests — electrocardiogram, EEGs, EKGs, blood tests, nuclear scan, coronary angiography, MRIs, MRAs and CT scans — to diagnose a heart attack, or rule it out. Failure to do this in a prompt manner can be utterly devastating for patients and their families.

Now, Swiss researchers have devised a new test that may help eliminate some of the uncertainty — and danger — associated with delayed diagnoses of heart attacks.

The test utilizes extremely sensitive measurements of cardiac troponins to determine the likelihood that a patient is suffering a heart attack in under an hour. For those unfamiliar with the term, cardiac troponins are proteins secreted by damaged heart tissue.

Medical professionals do have a cardiac troponins test at their disposal today. However, this current test is designed to detect extremely high levels of the protein, which are generally present only after the heart muscle has begun to suffer substantial damage, by which time it may be too late to prevent permanent injury.

Also, the current test can take up to six hours to rule out a heart attack – a fact which might delay the diagnosis and treatment of another serious condition if a heart attack is not the source of the patient’s distress.

In the study, the researchers used the new, more sensitive test on 436 patients who reported to emergency rooms with symptoms that could indicate a possible heart attack. The results were impressive to say the least:

  • Physicians ruled out heart attacks for 259 patients with 100 percent accuracy and diagnosed 76 patients as having heart attacks
  • By comparison, the less sensitive (i.e., older cardiac troponins) test and its accompanying span of several hours, diagnosed heart attacks in only 64 patients

According to the researchers, the enhanced test can not only detect heart attacks more quickly, but also save time and space in emergency rooms.

While this medical advancement is certainly encouraging, it’s important to remember that it is by no means standard in hospitals. Accordingly, physicians must still take all of the necessary steps to ensure you or your family member are not suffering a heart attack. Remember, your health and the health of your loved ones should never be compromised because an emergency room is too busy or because a physician fails to conduct a proper differential diagnosis.

Source: The New York Times, “Heart-attack test rules out false alarms,” Kate Yandell, Aug. 20, 2012

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