� � Nov-18-2009
Gone are the days when people suffering from chest pains had to wait for long hours before their physician could detect the cause of the suffering or if the problem was owing to a heart attack. A new research undertaken by medical scientists hinted that a CT scan, something like a superior version of X-ray, is able to detect a heart attack much faster when someone suffering from severe chest pain is taken to the emergency room. Diagnosis with a CT scan is also an inexpensive affair compared to several other methods of diagnosing a heart attack.
It may be noted that on an average as many as six million people visit the hospitals in the United States with chest pain every year. However, only a small percentage of these people suffering from chest pain actually have a heart attack. Currently, physicians are using the CT scan more than ever as it is able to provide a profound and comprehensive vision of the internal organs of the body. However, the downside of using CT scans is that these medical devices emit a great deal of rays and this aspect may perhaps enhance an individual's odds of developing cancer.
Although it is yet to be ascertained whether diagnosis with the CT scans are worth taking the risk of developing cancer, findings of the new research on the subject recommends the use of these scans to exclude heart attacks in the emergency room of a hospital, despite the hazards posed by them to our overall health.
The new study undertaken by the medical experts in the United States involved as many as 749 subjects, all suffering from chest pain, at 16 major medical centers all over the country. All these patients were suffering from chest pains, but did not show any obvious indication of a heart attack even in the blood examinations or EKGs conducted on them. Nevertheless, the physicians attending on these patients were scared of sending them home before conducting more examinations.
According to Dr. Kavitha Chinnaiyan, the leader of the new research on the subject and a cardiologist with the William Beaumont Hospital located in the outskirts of Detroit, on an average 4 per cent to 13 per cent of patients suffering from chest pain would not have been diagnosed of a heart attack, and as many as 25 per cent of such patients would have died if they were not examined with CT scans.
Describing detection of heart attack in a patient suffering from chest pain as 'difficult', Dr. Sidney Smith, a former president of the American Heart Association from the University of North Carolina at Chapel Hill, said that one of the most familiar reasons for initiating legal action against any emergency room physician is that they often send patients suffering from chest pain home without detailed examinations and later, many of these patients come back to the hospitals enduring a heart attack.
During the study, CT scans were done on 50 per cent of the patients suffering from chest pain, while the remaining patients underwent the normal imaging examinations by means of a radioactive dye. Arteries of around 82 per cent of the patients who had CT scans were found to be clear and were released from the medical centers with immediate effect. Around 89 per cent patients in the second group that underwent imaging tests were also found to have regular arteries and were also sent home.
Incidentally, the study found that in both the groups, the percentage of patients who required a perfect, but insidious examination, such as angiography, to determine whether they ought to have any artery-opening balloon angioplasty process or a bypass surgery was virtually equal - approximately six to seven.
What, however, mattered was the expense and time consumed in detecting a heart attack with a CT scan and without it. While it was possible to diagnose patients with CT scan within just three hours, patients who were diagnosed through other methods took longer time - often over six hours. Even the expenses involved in diagnosis with CT scans cost much less - US $2,137 on an average, compared to US $3,258 when the normal imaging process was used.
According to Dr. Chinnaiyan, the leader of the new study and who has no economic relations whatsoever with any imaging company, besides being a faster and inexpensive method for detecting heart attacks in patients with chest pains, CT scans are also safe. Dr. Chinnaiyan made the reports of the study public at a heart association symposium organized in Florida recently.
It may be noted here that the research conducted by Dr. Chinnaiyan and her team was partly sponsored by Bayer Pharmaceuticals, a firm that manufactures items used for heart imaging. A number of medical professional engaged in the research receive research scholarships from Bayer Pharmaceuticals or other firm that manufactures heart imaging paraphernalia. Describing the findings of the study as 'promising', Dr. Smith, who was not involved with the research in any manner, said that the doctors were able to recognize a specific group of patients with chest pain that did not require hospitalization.
Nevertheless, despite being faster and cheaper, people are still apprehensive about the effects of radiation during diagnosis with CT scans. Compared to any standard X-ray that involves around 0.01 to 0.15 millisieverts (determination of a dosage), a CT scan emits a huge amount of radiation, as much as 10 to 15 millisieverts. This is much higher than a X-ray for mammogram that involves three millisieverts and just 0.005 millisieverts for a dental X-ray.
Conversely, people suffering from chest pain are usually admitted to a hospital and are then required to undergo frequent examinations that carry on for a number of days. This process may possibly combine to expose these patients to a very high collective dose of radiation.
According to Dr. Mariell Jessup of the University of Pennsylvania, who chaired the scientific panel at heart association symposium held in Florida recently, once a patient suffering from cheat pain has a CT scan and it establishes that he or she is not having a heart attack, they will not receive any more radiation.
Meanwhile, scientists are expecting that a further clear-cut representation of the hazards and advantages of using CT scans will emerge from a bigger research that is about to go in process under the leadership of Dr. Pamela Douglas of Duke's University. This study is being funded nationally and is estimated to cost US $32.5 million. The study headed by Dr. Douglas will not only be the biggest ever research undertaken for heart imaging, but will also be the sole study to observe the manner in which different imaging examinations eventually have an impact on the death rate as well as the percentage of heart attacks, strokes, hospitalization and other aspects owing to chest pain. Altogether, the study will involve as many as 10,000 patients suffering from chest pain both in the United States and in Canada.
According to Dr. Pamela Douglas, the primary issue is to find out whether we are helping to add up more cases of cancer as more and more people are being exposed to medical radiation.