Simple test may reduce hospital admissions for suspected heart attacks - study

PARIS, France -- A simple blood test can reduce unnecessary hospital admissions by pinpointing people seeking medical help for chest pain caused by something other than a heart attack, a study said Thursday.

Researchers said they had identified the optimal level of a protein called troponin in the blood below which a heart attack can be all but ruled out as the cause of chest pain.

In a trial of about 6,300 people who went to the emergency room with chest pain at four hospitals in Scotland and the United States, the test correctly identified about two-thirds of those who were not having a heart attack -- all had a troponin level under five nanograms (billionths of a gram) per deciliter (a tenth of a liter).

This meant everyone under this threshold could probably have been sent home instead of being admitted to hospital, the research team wrote in The Lancet medical journal.

"Implementation of this approach would reduce avoidable hospital admission and have major benefits for both patients and health-care providers," the researchers wrote.

But they underlined the approach should not be applied without consulting a patient's medical history and profile.

Chest pain is one of the most common causes of hospitalization worldwide, with international guidelines recommending that people who complain of chest pain be admitted for extensive testing. The vast majority do not have a heart attack.

"Until now there were no quick ways to rule out heart attack within the emergency department," lead author Anoop Shah from the University of Edinburgh said in a statement.

In a comment also carried by The Lancet, experts Louise Cullen and William Parsonage from the Royal Brisbane and Women’s Hospital in Australia, and Martin Than from Christchurch Hospital in New Zealand, urged further study before a troponin benchmark is determined for early discharge of people with chest pain.

source: interaksyon.com

Filipinos should closely watch their heart health, urges cardiologists

While February is Valentine month, romance is certainly in the air these days. But at Cardinal Santos Medical Center (CSMC), its medical experts are calling on Filipinos to take a closer look at their hearts—literally.

“There are four major risk factors for heart disease,” says Dr. Zenaida Uy, Chief Medical Officer for Cardinal Santos Medical Center (CSMC). “These are smoking, diabetes, hypertension, and high cholesterol. Outside of those, obesity as well as family history can also lead to cardiovascular complications.”

Identifying risks, however, is not the problem, explains Dr. Uy. She adds, “It is persuading those at risk to visit the doctor regularly. And in the event that they do visit, the bigger challenge is getting them to commit to a healthier lifestyle.”

Heart disease is deeply rooted in basic lifestyle choices—particularly in diet and exercise. Eating excessive amounts of red meat or smoking cigarettes ultimately take their toll in the long run, advises Dr. Uy.

“It is all about healthier habit formation,” she asserts. “Nonetheless, most Filipinos forego preemptive behaviors in favor of instant gratification. But once this horrid disease has taken hold of your body, everything changes; at this point, your past choices can no longer be undone.”

Heart disease costs over P500K
The World Health Organization (WHO) ranks coronary artery disease (CAD) as the leading cause of death in the Philippines. According to the National Statistics Office (NSO), cardiovascular diseases are responsible for at least five of 10 deaths in the country. In 2011 alone, this prevalent type of heart disease was responsible for 57,864 Filipino fatalities—that is over five times more than the death toll of Super Typhoon Yolanda.

“When a doctor suspects a patient has CAD, an angiogram is immediately recommended,” narrates Dr. Uy. “If critical artery blockages are found, that patient will need to undergo angioplasty or bypass surgery as well.”

According to Dr. Uy, both operations would cost around Php500,000 (easily more in severe cases). And if you consider medicines, she adds, a patient needs to spend Php5,000 to Php8,000 in order to manage the condition.

“And that is just financially,” warns the cardiologist. “The severe chest pains you have to endure and the emotional toll that burdens your friends and family cannot be expressed in Pesos. Worst of all, CAD—and heart disease in general—could be avoided.”

Commit to a healthy lifestyle
Forming habits centered on healthier choices go a long way in securing a person’s health and wellness. And Dr. Uy says this begins with “a well-balanced diet and an effective exercise regimen.”

She elaborates, “Low-fat and low-salt diets should be complemented by a moderate exercise routine at least 45 minutes a day, five times a week. You may also opt for more strenuous exercises at a lesser frequency.”

“Most Filipinos dread exercise, but it really depends on how you frame it,” notes the doctor. “I always advise couples to look at exercise as a bonding experience—an activity that not only maintains their health but also strengthens their relationship.”

She concludes, “Your body has a remarkable capacity to maintain your health. All you have to do is commit to healthier choices.”

source: interaksyon.com

Warnings of 'sudden' cardiac death may come weeks early - study

Signs of approaching "sudden" cardiac arrest, an electrical malfunction that stops the heart, usually appear at least a month ahead of time, according to a study of middle-age men in Portland, Oregon.

"We're looking at how to identify the Tim Russerts and Jim Gandolfinis -- middle aged men in their 50s who drop dead and we don't have enough information why," said Sumeet Chugh, senior author of the study and associate director for genomic cardiology at the Cedars-Sinai Heart Institute in Los Angeles.

Some 360,000 out-of-hospital cardiac arrests occur each year in the United States, largely involving middle-aged men, with only 9.5 percent surviving, according to the American Heart Association.

Patients can survive if they are given cardiopulmonary resuscitation or CPR immediately and their hearts are jolted back into normal rhythm with a defibrillator.

Earlier clinical trials have focused only on symptoms or warnings signs within an hour of such attacks.

But Chugh's study set out to determine whether signs and symptoms occurred as much as a month before sudden cardiac arrests.

Researchers went back and examined medical records of men 35 to 65 years old after they had out-of-hospital attacks. In addition, paramedics reaching the scene of fatal attacks asked family members what signs and symptoms the patient may have had in preceding weeks.

Among 567 men who had "sudden" arrests, researchers determined 53 percent had symptoms beforehand. Among those with symptoms, 56 had chest pain, 13 percent had shortness of breath and 4 percent had dizziness, fainting or palpitations.

About 80 percent of symptoms happened between four weeks and one hour before the cardiac arrest, researchers said. And although most men had coronary artery disease, just half had been tested for it before their attacks.

"The findings were entirely unexpected," Chugh said. "We never thought more than half of these middle-aged men would have had warning signs so long before their cardiac arrests. Previously we thought most people don't have symptoms so we can't do anything about it."

Chugh said most people who have the same kinds of symptoms don't go on to have cardiac arrests.

"Even so, they should seek medical care," he said. "The message here is, if you have these signs or symptoms, please don't ignore them: seek healthcare."

Chugh said he and his colleagues are also attempting to identify people at risk by comparing biologies of those that have had sudden cardiac arrests with sample populations in Portland that have never had cardiac arrests.

The new findings, from the 11-year-old "Oregon Sudden Unexpected Death Study," were presented on Tuesday at the annual scientific sessions of the American Heart Association being held in Dallas.

The researchers are conducting similar studies among women. The ongoing study is being funded by the US Centers for Disease Control and Prevention, AHA and the Doris Duke Charitable Foundation.

source: interaksyon.com