Quick guide to heart symptoms found

Press, 14 June 1984, Page 18

Quick guide to heart symptoms found

AP Boston A 20-second computation with a pocket calculator could eliminate 250,000 hospital admissions a year in the United States and save hundreds of millions of dollars by helping doctors decide whether people with chest pains have serious heart troubles, a study shows.

Doctors admit 1.5 million people in the United States to coronary intensive care units each year. More than half the time, there is nothing wrong with their hearts and the hospital stays are unnecessary. This occurs because symptoms of heart attacks and serious angina pain are often confusing. Muscle strain, indigestion or other aliments can mimic the symptoms of serious heart disease.

To help make these diagnoses more accurate, researchers at Boston University Medical School developed a formula that reveals the chances that patients’

problems are caused by too little blood reaching their hearts, a condition known as acute ischemia. This is a key piece of information in deciding whether to admit them to hospital. Using this formula, doctors can punch a few numbers into a programmable calculator and learn the percentage chance that the patient has ischemia. "It's cheap, accurate and it works in a wide range of hospitals," said Dr Harry Selker. one of the researchers. The doctors described the process in the "New England Journal of Medicine" and predicted it would cut the number of admissions to United States coronary intensive care units by more than 250,000 a year if used evervwhere.

In the same journal issue, Harvard doctors calculated that patients who are mistakenly admitted to these coronary units run up bills of $4OOO on average before they are sent home. If these costs were the same every-

where, using the new formula could save America a billion dollars annually in needless medical expenses. Doctors tested the calculators on 2320 patients admitted to six hospitals of varying size and sophistication across New England. In a comparison, physicians who knew the results of the calculation admitted 30 per cent fewer patients with no serious heart trouble.

The total percentage of patients admitted to coronary care who did not have ischemia fell from 44 per cent to 33 per cent when the calculator was used. However. there was no increase in the number of missed cases of real heart trouble.

The formula is based on seven questions: whether the patient has chest pains, whether the chest pain is the patient's worst symptom, whether the patient has ever had a heart attack or taken nitroglycerin and three specific findings on electrocardiograms.