Quicker Chest Pain Screening in Emergency Rooms

Photo: Ambulance

Eight million Americans visit U.S.
emergency departments for chest
pain each year; © SXC

Computed tomography angiography (CTA) offers a way to more quickly and cost effectively identify patients at low-risk of cardiac problems like the blocked arteries that lead to heart attacks, according to the new University of Pennsylvania School of Medicine research. CTA has been the subject of debate within the Center for Medicare & Medicaid Services, which has yet to make a decision on whether to pay for the test in emergency room settings.

Anna Marie Chang, MD, a physician in Penn’s department of Emergency Medicine, and her colleagues studied 568 Hospital of the University of Pennsylvania chest pain patients who were screened for acute coronary syndromes using CTA. Negative scans were found to be an accurate, quick method of identifying patients who are safe to be immediately discharged from the emergency department.

Thirty days after leaving the hospital, no patients in the study group who had negative CTAs died from cardiac related causes, had heart attacks or required the placement of cardiac stents to open blocked arteries. Previous studies, by comparison, have shown that stress testing, the traditional screening method, is associated with a high rate of return emergency room visits and hospital admissions.

Costs for patients who received immediate CTA in the emergency department averaged about $1,240, while costs of stress testing and telemetry monitoring topped $4,000 for each patient. CTA also helped get low-risk chest pain patients home faster, potentially reducing emergency room crowding, study patients who received immediate CTA were discharged after an average of 8 hours, compared to more than 24 hours for those who received stress tests or were admitted for telemetry monitoring.

MEDICA.de; Source: University of Pennsylvania School of Medicine