Imagine coming to the hospital with crushing chest pain, only to find that emergency room doctors are uncertain whether youre having a heart attack. The electrocardiogram (ECG) is inconclusive and the blood tests that detect heart damage are normal. The only thing to do is wait, hour after hour, as doctors repeat the tests several times and scrutinize the results for diagnostic clues.
Soon, the wait may be much shorter. According to research reported in the February 27, 2007, issue of the Journal of the American College of Cardiology (JACC), a computed tomography (CT) scan of the heart can quickly detect whether there are fatty blockages or pockets of rock-hard calcium in the arteries of the heartclues that coronary artery disease may be the cause of the chest pain.
"The new 64-slice CT scanners give us amazing pictures of the heart," said James A. Goldstein, M.D., F.A.C.C., Director of Research and Education in the Division of Cardiology at William Beaumont Hospital, Royal Oak, MI. "With this very simple outpatient scan, you can rapidly determine whether the arteries are normal or abnormaland if theyre abnormal, whether the disease is mild, moderate, or severe."
Those who get a clean bill of health can safely go home from the hospital without further testing. "As a physician, its tremendously satisfying to tell an anxious patient, within about 30 minutes, that their heart and arteries are normal," Dr. Goldstein said.
Each year, some 6 million people in the United States are rushed to the emergency room with chest pain. At least half have inconclusive early test results; of these, approximately 65 percent are eventually found not to have suffered a heart attackbut not before racking up diagnostic costs totaling $10 billion to $12 billion annually.
Even low-risk patients with no history of heart disease can spend 18 to 24 hours in the emergency room as doctors repeat the ECG and blood tests. Thats because doctors
Contact: Amy Murphy
American College of Cardiology