Doctors Miss 85 Percent of Post-Surgery Heart Attacks

Tuesday, 18 Feb 2014 04:52 PM

By Nick Tate

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More than eight million people worldwide have heart attacks or cardiac injuries following surgery, but nearly nine in 10 are missed because they don't have symptoms — causing the sudden death of about 10 percent of patients, a new study suggests.

But according to the research, published in the journal Anesthesiology, a simple blood test following surgery could help identify such cases and save countless lives.
Medical News Today reports that only 15 percent of patients who have post-surgery heart attacks experience "traditional symptoms" — such as sudden intense pain, nausea, or indigestion — according to the new study by P.J Devereaux, M.D., head of cardiology at the Juravinski Hospital and Cancer Centre in Ontario.
"Most surgical patients who suffer a heart attack or injury will do so within the first 48 hours after surgery," Dr. Devereaux explained. "During this time, most of these patients are typically taking pain medications, which can mask the symptoms of a serious heart injury."
But he and his team suggested a new diagnosis, called Myocardial Injury after Noncardiac Surgery (MINS), would help doctors by including a broader definition of heart attacks. In addition, the researchers suggested measuring blood levels of troponin — a protein released into the blood when the heart is injured — would help identify those patients who are at risk of a heart attack.
The team assessed more than 15,000 patients in the first three days after non-cardiac surgery for troponin. After determining which patients had in fact suffered post-surgery heart attacks or injury, the researchers found that only 15 percent experienced chest pain or other heart attack symptoms. In addition, the team discovered that without monitoring troponin levels, 85 percent of the patients who suffered heart attacks or injuries would have gone undetected.
Any patients with elevated troponin levels were given an electrocardiogram to evaluate damage to the heart.
"The ease and feasibility of the test to detect heart injury point to tremendous opportunities for designing clinical studies to test novel interventions for attenuation (or reduction) of myocardial injury and perioperative mortality," said Karsten Bartels, assistant professor at the University of Colorado School of Medicine in Denver, in an editorial accompanying the study.

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