According to recent reports thousands of people with chest pains are dying unnecessarily because the NHS is using outdated testing methods that do not identify those at risk of heart problems, the health service rationing body has warned. The tests, which involve monitoring the heart while the patient is exercising on a treadmill, should be replaced with scans in some cases, the National Institute for health and Clinical Excellence said in new guidelines.
The new guidelines warn that the old fashioned test could lead doctors to wrongly assume that the patient's symptoms were not heart related if exercising did not trigger the problems. Prof Adam Timmis, Chairman of NICE's clinical guideline group, said some patients who went through NHS chest clinics had their pain wrongly dismissed as not heart related and then died or suffered a heart attack as a result. He suggested that this may be because clinicians were using the exercise test, which has been around for 50 years. Chest pain accounts for 25% of emergency admissions to hospital and 1% of visits to GPs, according to NICE - which issues guidance for England and Wales.
The tests are vital to diagnose the cause of pain so appropriate treatment can begin which may avoid the patient having a heart attack. Patients with new chest pain who were suspected of suffering from certain types of heart attack or angina should be given an electrocardiogram as soon as possible, which could be in the GP's surgery or in an ambulance on the way to hospital, the guidance added.
1.4 million people have angina, 300,000 have a heart attack and around 110,000 die annually as a result of heart problems. Chest pain affects up to 40 per cent of the population at some point in their lives and accounts for 700,000 visits to A&E departments and a quarter of hospital admissions.
Unfortunately, there is only one centre in the UK providing the current recognised state-of-the-art scan, Dual-Source CT Definition and this is the CIRC at The Wellington Hospital under the leadership of Professor Lahiri.
