Nuclear-imaging test can help doctors rule out heart attack

Tuesday, December 3rd 2002, 12:00 am

By: News On 6

CHICAGO (AP) _ Nuclear-imaging technology already in place at many U.S. hospitals can help emergency room doctors do a better job of ruling out heart attacks in patients with chest pain, a study found.

The study looked at sestamibi imaging, which is normally used in non-emergency settings as part of a stress test. The patient is injected with an isotope that lets doctors monitor the heart's pumping ability and see how much blood is flowing to it.

``We're just taking available technology and using it in a new way,'' said the study's lead author, Dr. James Udelson of Tufts-New England Medical Center in Boston.

More than 6 million people each year go to emergency rooms with chest pain, and many are admitted to the hospital or an observation unit because doctors are unable to rule out a heart attack.

If the patients have abnormal readings on electrocardiograms, doctors can diagnose their heart attacks with certainty and start treatment. Often, however, patients have normal electrocardiograms. These people are frequently admitted for observation.

The research appears in Wednesday' Journal of the American Medical Association.

The study found that 52 percent of patients who were not given the test were admitted with what turned out to be neither a heart attack nor unstable angina, a common precursor to a heart attack. The rate was 42 percent among patients who were given the test.

Dr. Robert Bonow, president of the American Heart Association and chief of cardiology at Northwestern University Medical School, said that number could fall once doctors using the test develop confidence in it.

Bonow said the imaging could save money, because an overnight stay in the hospital would probably be more expensive than the test.

The study looked at 2,475 patients at seven hospitals, ranging from large, academic medical centers to smaller community hospitals. Of the patients, 1,260 were assigned to receive standard care and 1,215 to undergo the imaging.