CT Scans Not Very Helpful in Diagnosing Heart Attacks

Obstetrician 1: Get the EEG, the BP monitor, and the AVV.
Obstetrician 2: And get the machine that goes ‘ping!’.
Obstetrician 1: And get the most expensive machine – in case the administrator comes.
—From Monty Python’s movie “The Meaning of Life”

Heart attacks remain the number one cause of death for men and women in the U.S. Heart attacks typically feel like squeezing or pressure in the center of the chest that lasts longer than a few minutes. ” target=”_blank”>study in this week’s New England Journal of Medicine. They conducted a study in which patients presenting to emergency departments with chest pain and whose initial EKG and troponin was normal were randomized to either usual care or an immediate CT scan of their coronary arteries.

The results were meh. The group which received the CT scans went home 7.6 hours earlier on average, but they received a dose of radiation and they were exposed to intravenous contrast, which can cause side effects. The overall cost of care was higher in the group receiving the CT. And in the outcome that really matters – catching every person with a heart attack – both groups did equally well.

” target=”_blank”>CT for chest pain in ER gets patients home sooner (Los Angeles Times)
” target=”_blank”>Coronary CT Angiography versus Standard Evaluation in Acute Chest Pain (New England Journal of Medicine article)
” target=”_blank”>In Event of a Heart Attack Let the Paramedics Come to You (My post in 2008 about what to do in case of a heart attack)

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