Featured Research

from universities, journals, and other organizations

Could heart attack patients could be treated more quickly?

Date:
July 25, 2014
Source:
Manchester University
Summary:
Clinical judgement, combined with an electrocardiogram (ECG) and blood test on arrival, is effective in reducing unnecessary hospital admissions for chest pain, a new study shows. The findings of a research group could potentially make a huge difference to a large number of patients. Researchers assessed the diagnostic accuracy of emergency doctors’ clinical judgement for acute coronary syndromes – both alone and in combination with the tests available on arrival – ECG and a blood test which detects a protein called troponin.

Clinical judgement, combined with an electrocardiogram (ECG) and blood test on arrival, is effective in reducing unnecessary hospital admissions for chest pain, a new study shows.

Related Articles


The findings of a research group in Manchester, published in the Emergency Medicine Journal, could potentially make a huge difference to a large number of patients.

Chest pain is the most common reason for emergency hospital admission. In Manchester, the incidence of premature death due to heart disease and stroke is amongst the highest in England.

Previous research has shown that typical symptoms in patients presenting to emergency departments have not been useful in differentiating between heart conditions requiring immediate hospital admission (acute coronary syndromes; ACS), and non-cardiac conditions.

This is because the symptoms of patients with heart disease can be similar to those experienced by patients with non-cardiac conditions, such as indigestion. However, the role of overall clinical judgement has not been extensively studied.The latest research, led by Dr

Richard Body, Consultant in Emergency Medicine at Manchester Royal Infirmary, assessed the diagnostic accuracy of emergency doctors' clinical judgement for acute coronary syndromes -- both alone and in combination with the tests available on arrival -- ECG and a blood test which detects a protein called troponin.

The study was undertaken at Stockport NHS Foundation Trust, where doctors in the emergency department recorded their overall clinical judgement for ACS using a five-point Likert scale (from 'definitely ACS' to 'definitely not' ACS). This data was then compared with patients' outcomes, including heart attack or the occurrence of major adverse cardiac events within 30 days.

The results showed that for patients who are suspected to have an ACS, clinical judgement cannot be relied upon by itself to rule out or rule in that diagnosis. However, when combined with an ECG and troponin test clinical judgement appeared to be an effective tool and the results suggest that at least 25 per cent of patient admissions could have avoided. The study also suggested that this was the case regardless of whether the clinician was a consultant or junior doctor.

Dr Rick Body, who is also National Institute for Health Research Postdoctoral Research Fellow and Honorary Lecturer in Cardiovascular Medicine at The University of Manchester, said: "I think the beauty of this technique is its simplicity. For years we've been working hard to improve our technology and our tests for heart attacks. This research suggests that, if the initial tests are normal and the doctor thinks that the diagnosis of a heart attack is unlikely, it may be perfectly safe to reassure patients that they do not have a heart attack without relying on further tests and observation in hospital.

"It is still early days but the study, which was funded through an NIHR Clinical Lecturer grant and a College of Emergency Medicine Research Grant, could potentially make a huge difference to large numbers of patients.

"In order to ensure the safety of patients, further research is still vital to ensure that our findings can be repeated with different groups of doctors and patients. We will also need to know if doctors would be confident enough in their judgement to use the technique in practice."


Story Source:

The above story is based on materials provided by Manchester University. Note: Materials may be edited for content and length.


Journal Reference:

  1. R. Body, G. Cook, G. Burrows, S. Carley, P. S. Lewis, J. Jarvis, B. Haves. Can emergency physicians 'rule in' and 'rule out' acute myocardial infarction with clinical judgement? Emergency Medicine Journal, 2014; DOI: 10.1136/emermed-2014-203832

Cite This Page:

Manchester University. "Could heart attack patients could be treated more quickly?." ScienceDaily. ScienceDaily, 25 July 2014. <www.sciencedaily.com/releases/2014/07/140725080337.htm>.
Manchester University. (2014, July 25). Could heart attack patients could be treated more quickly?. ScienceDaily. Retrieved October 25, 2014 from www.sciencedaily.com/releases/2014/07/140725080337.htm
Manchester University. "Could heart attack patients could be treated more quickly?." ScienceDaily. www.sciencedaily.com/releases/2014/07/140725080337.htm (accessed October 25, 2014).

Share This



More Health & Medicine News

Saturday, October 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Texas Nurse Nina Pham Cured of Ebola

Texas Nurse Nina Pham Cured of Ebola

AFP (Oct. 25, 2014) — An American nurse who contracted Ebola while caring for a Liberian patient in Texas has been declared free of the virus and will leave the hospital. Duration: 01:01 Video provided by AFP
Powered by NewsLook.com
IKEA Desk Converts From Standing to Sitting With One Button

IKEA Desk Converts From Standing to Sitting With One Button

Buzz60 (Oct. 24, 2014) — IKEA is out with a new convertible desk that can convert from a sitting desk to a standing one with just the push of a button. Jen Markham explains. Video provided by Buzz60
Powered by NewsLook.com
Ebola Protective Suits Being Made in China

Ebola Protective Suits Being Made in China

AFP (Oct. 24, 2014) — A factory in China is busy making Ebola protective suits for healthcare workers and others fighting the spread of the virus. Duration: 00:38 Video provided by AFP
Powered by NewsLook.com
WHO: Millions of Ebola Vaccine Doses by 2015

WHO: Millions of Ebola Vaccine Doses by 2015

AP (Oct. 24, 2014) — The World Health Organization said on Friday that millions of doses of two experimental Ebola vaccines could be ready for use in 2015 and five more experimental vaccines would start being tested in March. (Oct. 24) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins