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Heart of the Matter

Scott LaFee on

You're having chest pains. An ambulance rushes you to an emergency room where physicians begin a battery of exams, including CT scans and cardiac stress tests, to determine whether you're having a heart attack. It's reassuring, but is it necessary?

Researchers at Washington University in St. Louis suggest not. In published findings, they said neither CT scans nor cardiac stress tests actually provide information about whether a patient is in the midst of a heart attack. A more accurate measure is a newish blood test that measures levels of a protein called troponin. High troponin levels signal injury to the heart.

The unnecessary testing, they said, adds cost and time: More than $500, on average, and eight hours to the ER visit.

"It's important to keep in mind that CT scans and stress tests are used to diagnose coronary disease, whether someone has plaque in the arteries," said Dr. David Brown, senior author of the study. "Many people have coronary plaque but are not having a heart attack.

"The goal of evaluating patients with chest pain in the ER is not to screen for coronary artery disease. Anyone who goes to the ER for chest pain and gets sent home should make an appointment to see their primary care doctor to talk about their recent hospital visit. It's important to follow up to see if additional testing is warranted because screening tests are not appropriate in this specific emergency situation."

Body of Knowledge

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A normal breath takes five seconds: two to inhale, three to exhale. A normal swallow takes eight to 12 seconds, from mouth to stomach.

Get Me That, Stat!

The rate of self-inflicted injury among young girls ages 10 to 14 jumped nearly 19 percent between 2009 and 2015, according to new data published in JAMA. The figure underestimates the actual rate because it includes only adolescents who were taken to emergency rooms and not those treated in other settings or not at all.

Life in Big Macs

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