In a new study, researchers found that advanced heart tests for chest pain should not be routine for all patients with chest pain.
These tests are only necessary when initial assessments indicate heart disease is likely to happen.
The research was conducted by a team from UC Davis Health and Oregon Health Sciences University.
In the study, the team examined records of 619 chest pain patients were reviewed for initial and advanced tests they received in the hospital.
found that most patients with chest pain did not experience major cardiac events within six months following discharge.
In addition, the few study participants who had major cardiac events within six months of discharge were not identified by cardiac testing they received while in the hospital.
The findings confirm that advanced cardiac tests are not necessary for everyone.
They also point to the need for new tools to more accurately predict the possibility of a heart attack.
The team said that chest pain should always be a cause for alarm and initiate a rapid medical response to see if it is a symptom of a blocked artery or heart attack.
That response needs to include a complete medical history focused on common heart disease risks such as smoking, high blood pressure, and diabetes.
Doctors should use electrocardiograms to assess for evidence of heart damage or decreased cardiac blood flow. They also need to use troponin tests to identify heart muscle injury.
If all indications at that point are negative, there is usually little reason to do additional tests such as cardiac nuclear scans, stress tests, and angiograms.
These tests will only increase time in the hospital and costs and pose additional risk without increasing diagnostic value.
The senior author of the study is Ezra Amsterdam, professor of cardiovascular medicine at UC Davis Health.
The study is published in the American Journal of Cardiology.
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