Showing posts with label heart attack analysis. Show all posts
Showing posts with label heart attack analysis. Show all posts

Monday, June 30, 2008

Analysis Shows Heart Attacks Under-Treated Following Hospitalization

According to an analysis published Junes 23 in the Archives of Internal Medicine, one in five patients experience angina (chest pain) within the first year after a heart attack, at least once a week. The association was strongest in younger patients, those who have had coronary bypass surgery (CABG), smoke, experience depression and had symptoms at rest during hospitalization. The study was led by Dr. Thomas M. Maddox, from the Denver Veterans Affairs Medical Center, Colorado. Data was obtained from the Prospective Registry Evaluating Outcomes After Myocardial Infarction: Events and Recover (PREMIER) registry.

Co-author, Dr. John S Rumsfeld (Denver Veterans Affairs Medical Center) believes smoking and depression should be a major focus that physicians should target to help patients improve outcomes after experiencing a heart attack. He urges doctors to remain vigilant during the first year in order to provide continuous care to this sector of patients. “Right now our healthcare system is set up to provide care in small episodes: either you’re in the hospital or not, or in the clinic or not - and that’s not a patient- centered healthcare model", says Dr. Rumsfeld.

What happens at home, after a patient is discharged from the hospital and returned to the care of their primary physician, is a concern. Dr. Rumsfeld believes that care following a heart attack requires some quality improvements to “make a real difference to patients’ quality of life and how long they live.”



It’s normal to experience depression after a heart attack. Many patients have difficulty with smoking cessation. Past studies have shown that depression alone accelerates the risk of poor outcomes, including re-hospitalization, recurrent chest pain and greater physical limitations(1). Studies also show that younger women are more prone to depression after a heart attack.(2)

Patients and family members can take an active role by reporting symptoms of depression and ongoing chest pain. It’s important to understand that self-help includes compliance with medication and open communication with your family physician. The American Heart Association has valuable resources for patients and caregivers. You can visit their site for more help and information about a “heart healthy life”. Don’t leave it all up to your doctor – take an active role in your care and discuss treatment options for smoking cessation, treatment of depression and cardiac rehabilitation programs.


(1)http://www.theheart.org/article/746501.do
(2)http://www.theheart.org/article/690835.do

Ref: http://www.theheart.org/article/877761.do
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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. ◦
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