Improved Technique Speeds Chest Pain Assessment
A study presented by a team from the University of Pennsylvania at the Society for Academic Emergency Medicine noted that computed tomography angiography (CTA) offers an improved means to evaluate patients who present to the emergency room complaining of chest pain.
The team evaluated data from more than 568 patients who were seen at the Hospital of the University of Pennsylvania in the emergency room for chest pain. The patients were evaluated for acute coronary syndrome with high resolution CT scans (CTA). Patients who had negative scans were immediately discharged from the emergency room.
Patients were followed thirty days after discharge from the emergency room. None of the patients from the initial cohort that had negative CTA studies died from causes related to cardiac disease or had morbidity associated with cardiac conditions.
The standard approach to assess these patients has been stress testing. However, patients deemed negative with this approach often return to the emergency room or require future hospitalization.
Data reveals that the modified technique can identify those patients who are less likely at risk for heart attack. An additional benefit of this approach is the decreased amount of time required to complete assessment and lower costs.
CT costs were estimated at $1,240 whereas stress tests and additional assessment, such as monitoring with telemetry, cost over $4,000. Patients who underwent CTA were often discharged within eight hours, one-third of the hospitalization time for those who underwent stress testing.
The research presented suggests that standard assessment protocols utilized in the emergency room may require modification. Importantly, the Centers for Medicare and Medicaid Services (CMS) has not yet issued a rule about use of CT in the emergency room.
June 4, 2008 Related topics: New Technology & Innovation, Imaging, Diagnostic, Emergency, Cardiology