OPPapers.com

Heart Attacks

NEW ORLEANS — People who show up at a hospital with mild heart attack symptoms, but only ambiguous scores on medical tests, might still warrant emergency treatment, according to research presented at a meeting of the American Heart Association.

The new study, reported November 10 at the AHA’s annual Scientific Sessions meeting, suggests that getting some of these marginal patients into a heart catheterization lab within 24 hours causes no harm and sharply lessens their risk of having the problem recur over the following six months.

People with chest pains arriving in an emergency room get attention right away — for good reason. After ruling out those who are having acid reflux pain or an anxiety attack, doctors use an electrocardiogram (EKG) to assess the person’s heart function and a blood analysis to reveal any damage to the heart muscle.

These simple tests, coupled with obvious signs of distress, are often enough to diagnose a person suffering from a heart attack. Those patients are wheeled into a catheterization lab, where doctors thread a line from a leg artery up to the patient’s heart to open the coronary artery blockage that is causing the heart attack.

But only about one-third of people who show up with some measure of heart distress have such clear warning signs of a heart attack, says Deepak Bhatt, chief of cardiology at the Veterans Affairs Boston Healthcare System and an interventional cardiologist at Brigham and Women’s Hospital in Boston. The other two-thirds have EKG scores that are not clearly in the heart attack range, and/or have blood tests that may or may not reveal warning signs.

Physicians have struggled with the best emergency plan for these in-between patients, Bhatt says, particularly since many hospitals in smaller communities don’t have a catheterization team — which includes an interventional cardiologist, specialized nurse and technician — onsite around the clock.

To delineate clearly who among these heart patients in...