A highly detailed CT scan of the heart can safely and quickly rule out the possibility of a heart attack among many patients who come to hospital emergency rooms with chest pain, according to the results of a study that will be presented by researchers from the Perelman School of Medicine at the University of Pennsylvania today at the American College of Cardiology's 61st Annual Scientific Session and published concurrently in the New England Journal of Medicine. The multicenter randomized trial comparing coronary CT angiography (CCTA) and traditional cardiac testing methods revealed that chest pain patients with negative CT scans can be discharged safely from the hospital within hours. The findings may offer a new strategy for relieving the emergency room crowding that plagues many of America's hospitals, and could help to trim millions of dollars off the costs of care for one of the leading causes of ER visits.
Chest pain is the second most common reason people go the emergency room in the United States, accounting for as many as 8 million visits each year at a cost of several billion dollars. Just 5 to 15 percent of those patients are ultimately found to be suffering from heart attacks or other serious cardiac diseases, since issues from pneumonia to indigestion to anxiety can cause the same types of symptoms. But more than half of chest pain patients are admitted to the hospital for observation or traditional evaluation such as cardiac catheterization or a stress test.
"Until now, our methods for diagnosing patients with acute coronary syndromes in the emergency room setting have been both time-consuming and costly. We have spent the past 30 years trying to find a simple test that will tell patients, right now, 'It's not your heart.' This trial is the first time we've been able to accomplish that," said senior author Judd Hollander, MD, clinical research director in the department of Emergency Medicine and the senior author of the study.
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