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Most
people who go to the emergency room (ER) with chest pain
aren't having a heart attack, but it can take hours or days
to make a definitive diagnosis. However, a new study finds
that a special kind of CT scan seems to identify a heart
attack faster than traditional methods, so patients can be
sent home safely sooner. Researcher noted it can take 25
hours to get the results of blood tests that indicate
whether a patient has had a heart attack but using the CT
scan, diagnosis can be made faster. Two-thirds of heart
attacks will have an EKG that's not diagnostic. For every
100 patients who go to ER with chest pain, only 10 or 15
have cardiac disease, the other 90 percent have nothing
serious, researcher added. In addition, ERs are busy and
crowded, and this is a way to move patients out faster and
increase the ability to see more patients sooner. For the
study, more than 1,300 patients assigned with chest pain,
but no previous history of heart disease or risk factors
such as high blood pressure or diabetes, to CT scans or
regular care. The scans generate three-dimensional images of
the heart and the blood vessels surrounding it. Among those
with a normal scan, none died or had a heart attack within a
month after being seen in the ER. In addition, more of these
patients were sent home than those who received usual care
about 50 percent versus 23 percent, the researchers found.
Those who received scans spent less time in the hospital and
had heart problems diagnosed faster. There has been great
interest in developing strategies to more efficiently
evaluate these patients and identify which ones can be
safely discharged. The trial demonstrated that these scans
may be useful to screen low- to moderate-risk patients.
However, further studies are needed to evaluate the
cost-effectiveness of this strategy and how it compares to
protocols using high-sensitivity troponin tests, researcher
added. However, this test is usually repeated over 12 to 16
hours, so the results do not come back as quickly as a CT
scan. |