Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Some chest pain patients may benefit from more evaluation

01.11.2004


New research shows that almost 3 percent of patients who went to hospital emergency rooms with chest pain – but who weren’t initially diagnosed with heart problems – went on to have heart attacks or other heart-related events within a month.



The study, by Wake Forest University Baptist Medical Center researchers and colleagues from seven other medical centers, will be reported in the December issue of Annals of Emergency Medicine and is currently available on-line. "Not all chest pain is heart related and, unfortunately, some patients whose pain is diagnosed as non-heart related end up having heart attacks," said Chadwick Miller, M.D., lead researcher, from Wake Forest Baptist. "We wanted to know how frequently this happens and what characteristics these patients have in common that could help physicians in the difficult task of evaluating chest pain."

The researchers reviewed data from 15,608 patients who were evaluated for chest pain in nine hospital emergency departments between June 1999 and July 2001. All patients with a diagnosis of non-cardiac chest pain were contacted by phone, and researchers reviewed their hospital records to determine their outcome at 30 days. Other diagnoses included heart attack, low-risk chest pain, unstable angina and high-risk chest pain.


The analysis found that 2.8 percent of patients who were initially diagnosed with non-cardiac chest pain had definitive evidence of a heart attack, unstable angina, cardiac death or a procedure to re-open blocked heart vessels within a month after their diagnosis. Another 3.5 percent of the patients had possible evidence of an adverse heart event, but there was not enough information to say for sure.

Miller said these levels may seem relatively low, but would represent a significant level of death and illness on a nationwide scale.

There is no single, definitive test to diagnose heart attacks, making it difficult to evaluate chest pain patients, the researchers said. It is too costly to admit seemingly low-risk patients to the hospital for extensive testing. On the other hand, physicians do not want to miss a heart attack diagnosis.

Most doctors err on the side of caution, the researchers said. More than two-thirds of patients admitted to the hospital with chest pain are not having a heart attack. Physicians typically base treatment decisions on an initial impression from the patient’s history, physical exam and findings from an electrocardiogram. "This is a practical approach, but until this study, there was no information on the outcomes of patients with a diagnosis of non-cardiac chest pain," said Miller.

Causes of non-cardiac chest pain can include stomach disorders, blood clots in the lungs, pneumonia, chest wall disorders, and anxiety.

The researchers found that patients who were diagnosed with non-cardiac chest pain and then had heart events were older (61 year versus 48 years) and more likely to be men (60 percent versus 39 percent) than the patients who did not have events. Other factors associated with adverse cardiac events were high cholesterol, diabetes, a history of heart vessel disease and a history of congestive heart failure, which is when the heart does not pump enough blood to meet the body’s demands. "When the doctor’s initial impression is non-cardiac chest pain, further evaluation should be considered if the patient has high-risk features such as a history of heart vessel disease, older age and high cholesterol," said Miller.

The researchers said the findings could help improve care and reduce costs. "If we could use this new information to reduce the number of patients who have heart attacks after leaving the emergency department, quality will improve," said Miller. "Furthermore, if physicians can safely identify a group of patients who do not require additional evaluation, health care spending will decrease."

Karen Richardson | EurekAlert!
Further information:
http://www.wfubmc.edu

More articles from Studies and Analyses:

nachricht Smart Data Transformation – Surfing the Big Wave
02.12.2016 | Fraunhofer-Institut für Angewandte Informationstechnik FIT

nachricht Climate change could outpace EPA Lake Champlain protections
18.11.2016 | University of Vermont

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

Im Focus: MADMAX: Max Planck Institute for Physics takes up axion research

The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.

The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...

Im Focus: Molecules change shape when wet

Broadband rotational spectroscopy unravels structural reshaping of isolated molecules in the gas phase to accommodate water

In two recent publications in the Journal of Chemical Physics and in the Journal of Physical Chemistry Letters, researchers around Melanie Schnell from the Max...

Im Focus: Fraunhofer ISE Develops Highly Compact, High Frequency DC/DC Converter for Aviation

The efficiency of power electronic systems is not solely dependent on electrical efficiency but also on weight, for example, in mobile systems. When the weight of relevant components and devices in airplanes, for instance, is reduced, fuel savings can be achieved and correspondingly greenhouse gas emissions decreased. New materials and components based on gallium nitride (GaN) can help to reduce weight and increase the efficiency. With these new materials, power electronic switches can be operated at higher switching frequency, resulting in higher power density and lower material costs.

Researchers at the Fraunhofer Institute for Solar Energy Systems ISE together with partners have investigated how these materials can be used to make power...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

 
Latest News

UTSA study describes new minimally invasive device to treat cancer and other illnesses

02.12.2016 | Medical Engineering

Plasma-zapping process could yield trans fat-free soybean oil product

02.12.2016 | Agricultural and Forestry Science

What do Netflix, Google and planetary systems have in common?

02.12.2016 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>