If you're having chest pains, an advanced type of scan called called coronary CT angiography can quickly rule out a heart attack. New research suggests this might not necessarily be good for you.
These heart scans cut time spent in the hospital but didn't save money, the study found. They also prompted more tests and questionable treatments and gave relatively large doses of radiation to people at such low risk of a heart attack that they probably didn't need a major test.
There is no evidence that adding these tests saved lives or found more heart attacks, wrote Dr. Rita Redberg, a cardiologist at the University of California-San Francisco in an editorial in Thursday's New England Journal of Medicine. And since radiation from the scans can raise the long-term risk of developing cancer, doctors "may legitimately ask whether the tests did more harm than good," she wrote.
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None of this changes the advice to seek help quickly if you're having chest pain or other signs of a heart attack. Any delay raises the risk of permanent heart damage.
But more than 90 percent of the 6 million people who go to hospitals each year in the U.S. with chest pain have indigestion, stress, muscle strain or some other problem - not heart disease. Doctors are afraid of missing the ones who do have it, and increasingly are using CT scans - a type of X-ray - with an injected dye to get detailed views of arteries.
More than 50,000 of these scans were done in Medicare patients in 2010, and their use is growing. Far more than that were done in younger patients like the ones in this study, who were 54 years old, on average.
The aim of the study was to see whether the scans were faster, better or less expensive than usual care, such as simpler tests.
Researchers led by Dr. Udo Hoffmann at Massachusetts General Hospital enrolled 1,000 patients who went to one of nine hospitals around the country with possible heart attack symptoms. All showed no clear sign of a heart attack on initial tests - an electrocardiogram and blood work.
They were randomly assigned to either a CT can or whatever is standard at that hospital, such as a treadmill or other tests. CT scans led to more follow-up tests and treatments, even though only 8 percent of both groups turned out to have heart disease and only 5 of the 1,000 had had a heart attack.
Online
Study: bit.ly/NDbG21
Heart test info:
