Tuesday, January 15, 2008

Is Your Cardiologist Cranky? Analysis Reveals Unnecessary Cardiac Catheterizations.

An analysis published last month in the Journal of the American Medical Association reveals that 14% of patients who go to the emergency room for suspected heart attack are sent for cardiac catheterization unnecessarily. This means that the Cardiologist and the cardiac cath team are called to action to treat non heart attack patients - at any hour. No wonder your Cardiologist may be cranky.

Furthermore, 10% of "clot busting" medication is given to patients who later have no indication of heart attack.

The analysis was carried out by examining the prospective registry of a regional health system that transfers patients with suspected STEMI (ST elevation myocardial infarction) to a cardiovascular center in Minnesota for treatment. The investigation took place between March, 2003 and November 2006.

The goal of assessing the data was to determine how frequently this occurs and what factors contribute to misdiagnosis.

The results reveal that out of 1335 patients who received cardiac catheterization, 187 patients had no blockage in their coronary arteries, 9.5% did not have significant blockage, and blood tests indicative of heart attack were negative in 11.2% of these patients.

The outcome revealed that false positive cardiac catheterization laboratory activation is fairly commonplace.

Perhaps if the Cardiologist would examine patients in the Emergency room instead of relying on the diagnosis of the Emergency room physician, 1 in 10 patients would be spared this invasive procedure - but your Cardiologist might still feel cranky.

Ref: JAMA. 2007;298(23):2754-2760. ◦