A new test to assess chest pain in UK emergency departments can rule out the possibility of heart damage within six hours, allowing safe discharge of patients and reducing unnecessary admissions, finds a study in this week's BMJ. The current approach requires admission to hospital for a minimum of 24 hours.
Over a 12-month period, researchers at Manchester Royal Infirmary identified patients, aged over 25 years, attending the emergency department with chest pain.
The new test was compared with the current gold standard for diagnosing heart damage in 292 patients. Patients with a positive result were admitted to hospital. All other patients were discharged to the care of their general practitioners. Patients who were discharged were asked to return after two days.
The new test is accurate and effective at ruling out heart damage within six hours in these patients, say the authors. This has important clinical and economic implications as it would allow early discharge of patients who were shown not to be at risk of heart attack and it would facilitate early treatment of those who required it, they conclude.