Emergency doctors in Southampton are investigating whether patients who arrive at hospital with chest pain can be safely sent home earlier by streamlining tests currently used to diagnose, or rule out, heart attack.
Each year, around 6,000 people arrive at Southampton’s emergency department with chest pain. Usually, it is not a sign of anything serious but most will have to undergo a series of lengthy tests so doctors can determine if the pain is due to a heart attack or an unrelated condition.
Testing for heart attack
Currently, when a patient presents with chest pain, doctors carry out an electrocardiogram, or ECG, and two blood tests.
The blood tests are taken three hours apart and measure the levels of a protein, called troponin, in the blood. Troponin is normally present in blood in very small quantities but when there is damage to the heart muscle, such as during heart attack, it is released into the bloodstream and causes levels to rise.
If the results of both blood tests return as normal, doctors can be confident the patient has not suffered a heart attack and in many cases no further tests are needed so the patient can be sent home.
Reducing time in hospital
The study team, led by Dr Sanjay Ramamoorthy, a consultant in emergency medicine at University Hospital Southampton NHS Foundation Trust, are investigating whether this process can be made more efficient and if it is safe to discharge patients after the first blood test if results are normal.
“If the results from the first troponin blood test come back as undetectable, we may be able to send patients home quicker with no negative effect on their safety or long-term health,” explained Mr Ramamoorthy.
“If it is proven safe to discharge some patients after a single blood test, it will help to streamline the emergency care process, reduce wait and stay times for patients, and reassure larger groups of patients more promptly about their condition.”
This study is being funded by the National Institute for Health Research and results will be available in early 2019.
Posted on Monday 12 November 2018