Navigation Links
Study shows emergency physicians have good first instincts in diagnosing heart attacks
Date:7/23/2008

WINSTON-SALEM, N.C. A study out of Wake Forest University Baptist Medical Center demonstrates emergency room doctors are correctly identifying patients who are having a heart attack, even when laboratory tests haven't yet confirmed it.

The study used data from a registry called i*trACS, and analyzed patients with heart attack symptoms who were admitted to emergency departments (EDs) in eight participating U.S. centers.

The findings were released today in the Emergency Medicine Journal.

"One of the most common complaints we see in the Emergency Department is chest pain," said Chadwick Miller, M.D., lead author and assistant professor of emergency medicine at Wake Forest Baptist. "That's why it is so important to figure out if we're doing a good job of diagnosing and treating heart attacks, or if there's a better way to do it."

The patients in the registry were divided into three groups: no myocardial infarction (No MI), non-ST segment elevation myocardial infarction (NSTEMI), or evolving myocardial infarction (EMI).

The groups were determined by a blood test that measured levels of the protein troponin, which increases when the heart muscle is damaged from a heart attack.

Patients classified as No MI may have had symptoms but, according to the troponin levels throughout their hospital stay, did not actually have a heart attack. Patients classified as NSTEMI showed elevated troponin levels when first admitted, usually because their heart attack happened several hours or even days before coming to the ED. Patients classified as EMI did not initially show elevated troponin levels when presenting to the ED, but showed evidence of heart damage up to 12 hours later.

The study focused primarily on EMI patients. When a patient was admitted into the ED with heart attack symptoms, doctors at centers participating in the i*trACS registry would record their initial impressions of the symptoms exhibited by the patient. According to the results, the initial impression of the physicians showed that a higher percentage of them assigned a higher risk of heart attack to the EMI (76 percent) and NSTEMI (71 percent) patients, than the No MI (52 percent) group. As a result, the EMI patients were triaged to higher levels of care than the no MI group, despite the initial negative troponin results.

"There has been a lot of concern that clinicians either aren't spending enough time getting clinical history from patients or are not using the information they obtain," said Miller. "Patients with EMI are at particular risk for being evaluated less aggressively because their initial troponin result is normal, even though they have had a heart attack. This study suggests that although we are relying on better medical technology to diagnose patients, the clinical impression is still very important."

"It is reassuring to see that the admission patterns among the EMI patients were more aggressive than with the No MI patients, even though in both groups the patients' troponin results were not elevated. This suggests that clinicians are not allowing the non-elevated troponin results to overshadow their clinical impression."

The i*trACS registry was compiled over a period of 26 months. More than 17,000 patients were enrolled. However, only 4,136 of those patients were included in the analysis, primarily because patients had to have two troponin results within 12 hours to be included. Patients were also excluded from the i*trACS registry if they were pregnant, or under 18 years old.


'/>"/>

Contact: Shannon Koontz
shkoontz@wfubmc.edu
336-716-2415
Wake Forest University Baptist Medical Center
Source:Eurekalert

Related medicine news :

1. Study suggests human visual system could make powerful computer
2. Australian Study Seeks Genetic Roots of Cerebral Palsy
3. Cranberry juice creates energy barrier that keeps bacteria away from cells, study shows
4. Milestone for cannabinoid MS study
5. Broad Institute earns grant to support pathbreaking diabetes study
6. New Study Shows Facial Plastic Surgery Helps African American's Perserve Ethnicity
7. Raw deal for foreign brides in Taiwan: study
8. NEJM: Low-fat diets not best for weight loss: New study by Ben-Gurion U. of the Negev
9. After ER visit, many patients in a fog, U-M study finds
10. New study replicates association between genetic variation and antidepressant treatment response
11. LSUHSC study finds high-dose HBO2 therapy extends survival window after cardiopulmonary arrest
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... June 27, 2016 , ... ... authorized OSHA Training Institute Education Center headquartered in Northern California, has issued an ... extreme heat at their worksites. Employers with workers exposed to high temperatures ...
(Date:6/27/2016)... ... ... "FCPX editors can now reveal their media with growing colorful split screen ... - CEO of Pixel Film Studios. , ProSlice Color brings the split screens ... reveal the media of their split screens with growing colorful panels. , ProSlice Color ...
(Date:6/27/2016)... ... , ... TherapySites, the leading website and online ... Counseling Association. This new relationship allows TherapySites to continue to extend their ... benefits and promotional offers. , "TCA is extremely excited about this new partnership, ...
(Date:6/27/2016)... ... June 27, 2016 , ... ... strategic partnership with Connance, a healthcare industry leader providing predictive analytics to ... technology combine to provide health systems, hospitals and ambulatory surgical centers with ...
(Date:6/27/2016)... ... 2016 , ... A revolution is underway. Brooklyn-based company, ... for the millions of people who require these medical transport services annually. ... the use of technology. Now, SmartEMS has put forth an industry-changing app that ...
Breaking Medicine News(10 mins):
(Date:6/26/2016)... One of Australia,s successful biotechnology ... a new biotechnology company, Noxopharm Limited [ABN 50 608 966 123] ... to list on the ASX. Noxopharm is a clinic-ready ... a Phase 1 clinical study later this year. ... the biggest problems facing cancer patients - the ability of cancers ...
(Date:6/26/2016)... Jazz Pharmaceuticals plc (Nasdaq: JAZZ ... Antitrust Improvements Act of 1976, as amended ("HSR"), with ... ("Celator"; Nasdaq: CPXX ) expired effective June ... As previously announced on May 31, 2016, Jazz ... under which Jazz Pharmaceuticals has commenced a tender offer ...
(Date:6/26/2016)... , June 27, 2016  VMS Rehab Systems, Inc. ... will take whatever measures required to build a strong ... which is currently listed on the OTC Markets-pink current ... Chairman and CEO, "We are seeing an anomaly in ... understand, not only by the Company, but shareholders and ...
Breaking Medicine Technology: