New Heart Attack Test for Women
According to experts, if both a man and women visited the emergency room complaining of chest pains, the male would be twice as likely to be diagnosed with a heart attack than the female.
But this isn’t because twice as many men suffer from heart attacks than women. All of the tell-tale signs of cardiac arrest that you hear about – they don’t necessarily apply to everyone. So someone could be admitted with just chest pains and they could still be having a heart attack without any of the other well-known symptoms.
Obviously a medical emergency, early diagnosis and treatment of a heart attack could mean the difference between life and death. But the team has found out that heart attacks may be harder to detect in women. This could be down to women having seemingly milder attacks that don’t get picked up by the usual tests or ECGs, or simply that the symptoms differ.
At the moment, the NHS uses standard troponin tests to check for a heart attack. Troponin is a protein that signals that they might have been damage to the heart muscle, and thus the patient has experience a heart attack.
Doctors rely on troponin blood tests to help them judge whether or not a patient with chest pain is going through a heart attack. However, if the results of these tests come back as normal, then a heart-attack diagnosis could be passed over.
Scottish researchers from the Royal Infirmary of Edinburgh wanted to see if a more sensitive troponin test would make any difference against these worrying results. They set up clinical trials at the hospital, examining more than 1120 people – both men and women – who had been admitted with chest pains, and published their findings in the BMJ.
The study, funded by the British Heart Foundation, used to standard test to check out the troponin levels of all of the patients. The team found that 117 of the male patients (19%) were having a heart attack, compared to only 55 of the female patients (11%).
Researchers then used the new, high-sensitivity troponin test to see if and how those number varied. Using the new test, the team found that the number of women diagnosed with a heart attack actually doubled, making it 111 women having heart attacks – 22%, not 11%.
In addition, the more sensitive test managed to spot a couple of extra cases in the male patients. While this doesn’t sound like a lot, it does mean that these people could be treated for the heart attack they were having, without having their condition otherwise overlooked.
Analysing the results, the team realised that the additional cases picked up by the new test differed slightly than those using the standard test. These patients were actually at a higher risk of having another heart attack within a year – or even dying.
Dr Anoop Shah is one of the study authors. He explained that the findings suggest the troponin-testing threshold is too high when testing women, and that these levels should be adjusted depending on the gender of the patient.
“For some reason, women are less likely to have obvious symptoms,” Dr Shah said. He went on to explain that if half of the women having heart attacks are sent home with a negative diagnosis, they could end up having another cardiac event soon after simply because their condition isn’t treated.
Two versions of the test – troponin I and troponin T – have already been approved by the relevant regulatory bodies, though not all hospitals in the UK have moved on to the high-sensitivity test just yet.
The team said that more research, of which the trials have already begun, is required to verify that lowering the troponin threshold for women will actually save lives.
This is what the British Heart Foundation believes, according to its Medical Director, Professor Peter Weissberg. “Using a high-sensitivity troponin test could save many more women’s lives by identifying them earlier to take steps to prevent them dying or having another, bigger heart attack,” he said.
If you experience unusual chest pains, call an ambulance or get yourself to your local A&E. And it might be worth your while to ask whoever treats you if they have a high-sensitivity troponin test – it might just save your life.
For more information about heart attacks and their symptoms, please visit the NHS website.