High-Tech CT Scans Speed Diagnosis of Chest Pain

Time and money was saved in 75% of ER cases, study finds

By Ed Edelson
HealthDay Reporter

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MONDAY, Feb. 19 (HealthDay News) -- An advanced CT scan was 75 percent accurate in catching which patients who came to an emergency room with chest pain actually had serious heart problems, cardiologists report.

The findings could translate into savings of both time and money, along with fewer unnecessary hospitalizations, they added.

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"Ours is what I believe to be the first randomized study showing that multi-slice CT scanning improves the efficacy of diagnosis of people with chest pain," said study author Dr. James A. Goldstein, director of research and education in the cardiology division of William Beaumont Hospital in Michigan. His report is published in the Feb. 27 issue of the Journal of the American College of Cardiology.

Improved, quick diagnosis is important for the estimated 1 million Americans who come to emergency rooms each year with chest pains that could be a sign of serious heart trouble or simply a false alarm.

Those people now can spend up to 24 hours in the hospital as doctors do blood tests and perform electrocardiograms (ECGs). About 65 percent of those people eventually are found not to have had a heart attack, but many are hospitalized anyway, because doctors would rather err on the side of caution. The diagnostic cost of all that testing tops $10 billion a year, according to the study.

The Michigan researchers used a different approach with 197 people who came to emergency rooms with chest pains but no history of heart disease. Half were given the standard treatment. The other half were assigned to have CT scans of the heart, in which X-rays are first used to measure the amount of calcium in the arteries, and dye is then injected to get a detailed picture of the heart and its arteries, something than can be done in about 15 minutes.

CT scans alone were able to determine whether heart disease was the cause of the chest pains in 75 percent of the cases, the researchers found. The remaining 25 percent needed more tests. Even so, the average cost for diagnosing a patient with a CT scan was $1,586, compared to $1,872 for those given the standard approach, and the average time for diagnosis was 3.4 hours with CT scans, compared to 15 hours with the standard approach.

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