Thursday, August 22, 2019

Myths about atypical heart attack symptoms for women squashed

Quashing the myth that women tend to have 'atypical' symptoms during a heart attack, a new study has found that the women who suffer heart attacks show identical key symptoms as men.
The study published  emphasised the need for both sexes to recognise and act on the warning signs.


"Our concern is that by incorrectly labelling women as having atypical symptoms, we may be encouraging doctors and nurses not to investigate or start treatment for coronary heart disease in women," said a cardiology research nurse  and first author of the study.

"Both men and women present with an array of symptoms, but our study shows that so-called typical symptoms in women should always be seen as a red flag for a potential heart attack," she added.

Researchers recorded the symptoms of people attending the Emergency Department (ED) at Edinburgh Royal Infirmary who had a blood test called a troponin test.

This test is used when doctors suspect a person is having a heart attack and measures a protein released by damaged heart cells during a heart attack.

Between 1st June 2013 and 3rd March 2017, doctors in the ED ordered the troponin test for 1,941 people. Of these people, 274 were diagnosed as having a type of heart attack known as an NSTEMI (90 women and 184 men). This is the most common type of heart attack and occurs when the coronary artery is partially blocked.

Chest pain was the most common symptom for both men and women, with 93 per cent of both sexes reporting this symptom. A similar percentage of men and women reported pain that radiated to their left arm (48 per cent of men and 49 per cent of women).

More women had pain that radiated to their jaw or back and women were also more likely to experience nausea in addition to chest pain (33 per cent vs 19 per cent).

Less typical symptoms such as epigastric pain (heartburn), back pain, or pain that was burning, stabbing or similar to that of indigestion were more common in men than women (41 per cent in men vs 23 per cent in women).

Previous research has suggested that women and men report different heart attack symptoms. However, the symptoms were often recorded after a heart attack diagnosis was confirmed, which may introduce bias.

This study aimed to avoid this by asking an independent research nurse to interview and record the symptoms of all patients arriving at the ED with a possible heart attack before they were given a diagnosis.


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Thursday, February 08, 2018

Heart health measured with a simple blood test

Researchers have discovered a new indicator that measures the risk of future heart disease. High levels of this substance, called troponin, can identify people at risk. 
 
It's long been the holy grail of cardiac researchers: a simple blood test that can predict who is at greatest risk of developing heart disease. Cholesterol and C-reactive protein levels have long been used as proxies for this ideal indicator.

But two new studies document how individuals with heart disease had high levels of a protein, troponin, in their blood long before they had symptoms, compared to individuals who did not have heart disease.

The studies also show that an increase of troponin over time indicates an increase in the risk of heart disease.

A sign of disease
Doctors have long tested the blood levels of troponin in people who come to a hospital with chest pain to determine if they are having a heart attack.

"This is a well-known marker for heart disease," says  a researcher.

However, levels of this protein also vary in healthy people in the population.

Tested 9000 people
Researchers  relied on blood samples from several studies conducted by a Study. It is one of the largest population-based health surveys ever conducted. The researchers used information from the study to look for early signs heart disease risk, using methods that are different than those used in hospital clinics today.

None of the participants had symptoms of heart disease when blood samples were collected during the 2nd phase of the study, which was carried out from 1995-1997, and the 3rd phase of the study, which was carried out from 2006-2008.

Frozen blood samples from over 9000 participants were thawed and tested for troponin.

Participants' blood samples were divided into three groups, based on whether they had low, moderate or high values of the protein.

330 died of heart disease
The researchers then compared these findings with records of hospitalizations and deaths until 2010. By that time, roughly 8 per cent of the participants had had a heart attack or heart failure.

Of the participants, 330 had died from heart disease, 270 had had a heart attack, and 135 had been hospitalized with heart failure.

Among these three groups, many more had high troponin levels as early as 14 years previous to their diagnosed illness compared to individuals who did not develop heart disease.

None of the participants were known to have symptoms of heart disease when the blood tests were first taken.

The common denominator
Troponin appears to be a common denominator for various heart disease risk factors, such as high blood pressure and high cholesterol.

"It is a protein that is likely created by low grade heart failure. But we still do not know why people with heart disease have a higher levels of the protein many years before there is evidence of heart disease, compared to those without heart disease, "said a researcher.

Better than measuring cholesterol
The researchers found that troponin levels are more likely to predict who is at risk of heart disease than more familiar measurements such as C-reactive protein.

Troponin also appears to be a better predictor of future heart disease than high levels of dangerous cholesterol, according to the study.

Nevertheless, age, diabetes and high blood pressure that require medical treatment are even stronger predictors of future heart disease than troponin levels.

Preventative treatment a goal
Currently, troponin levels can only be tested in hospitals.

But scientists hope that a test can be developed so your GP can determine who is most at risk of future heart disease.

"These people can then be offered preventive treatment," says a scientist.

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Friday, August 28, 2015

'Heart attack’ blood test can predict future hypertension


A sensitive version of a blood test long used to verify heart muscle damage from heart attacks could predict future hypertension, says study.

A research team led by Johns Hopkins investigators found that people with subtle elevations in Cardiac Troponin were more likely to be diagnosed with hypertension within a few years.

Lead investigator Bill McEvoy said that identifying those at risk for hypertension as well as those in the earliest stages of the disease would allow them to intervene much sooner, either with lifestyle changes or medication, before the condition develops fully and has had a chance to damage organs.

Researchers said that the Standard Troponin test worked great for figuring out whether someone with chest pain or other cardiac symptoms was having a heart attack.

They added that the high-sensitivity test could identify these people, because it detected even trace amounts of troponin released by heart cells injured by spikes in blood pressure that went unnoticed.
In the study, McEvoy and colleagues analysed blood samples obtained in the late 1980s and early 1990s from 5,479 people.

None of the participants had clinical diagnosis of hypertension at the beginning of the study although a small subgroup had high-normal blood pressures, a condition that often heralds the onset of full-blown hypertension later on.

The researchers concluded that their data suggested that the high-sensitivity troponin test could flag people with normal blood pressure in the doctor’s office who were at high risk for hypertension and other poor outcomes.

The study is published in the Journal Circulation.

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