Chest Pain Duration Key To Diagnosing Heart Attack
September 12, 2013

Longer-Lasting Chest Pain More Indicative Of Heart Attacks

redOrbit Staff & Wire Reports - Your Universe Online

When trying to determine whether or not chest pain is the result of a heart attack, the duration of the discomfort is key, according to researchers from the Henry Ford Hospital in Detroit.

Patients who have longer-lasting chest pain are more likely to be experiencing a cardiovascular event than with pain of a shorter duration, the researchers report in this month’s issue of the journal Critical Pathways in Cardiology.

According to the hospital, between eight and 10 million Americans go to the emergency room annually because of chest pain – yet only 15 percent to 30 percent of them are actually having a heart attack. The study authors emphasize that the characteristics of the chest pain are vital to determining the cause.

“Patients can experience varying strength, location, and duration of chest pain,” explained Dr. James McCord, a cardiologist at Henry Ford Hospital and a member of the research team. He and his colleagues analyzed the relationship between the length of time that a patient experienced chest discomfort and the likelihood of heart attack diagnosis.

“The variety of symptoms any one patient may experience during a heart attack is a challenge to the physician who is trying to distinguish between patients who are having a heart attack and those who are not,” he added. “Although an electrocardiogram (ECG) and cardiac markers in the blood are important in the evaluation of patients with a possible heart attack, they are not 100 percent accurate.”

Dr. McCord’s team studied the records of patients who had been evaluated for a possible heart attack at Henry Ford Hospital’s emergency department between January and May of 1999. They selected only those patients for whom they had access to information regarding chest pain duration and 30-day follow-up data.

A total of 426 patients were included in the study. Of those, 38 of them (less than nine percent) received a final diagnosis of heart attack. Those individuals had an average chest pain duration of 120 minutes, while those who did not receive a heart attack diagnosis experienced just 40 minutes of chest pains. Furthermore, in patients who had chest pains lasting under five minutes, there were no heart attacks reported.

“These findings suggest that patients with chest pain lasting less than five minutes may be evaluated as an out-patient in their doctor’s office; while patients with chest pain greater than 5 minutes, without a clear cause, should seek prompt medical evaluation in an emergency department,” Dr. McCord said.

“The researchers concluded that patients with heart attack have longer duration of chest pain than those not experiencing a heart attack; patients with chest pain of short duration, less than 5 minutes, are unlikely to have a heart attack and have a good prognosis at 30 days,” the hospital added. However, since the study was conducted at one medical facility with a small sample size, Dr. McCord said that additional research is required.