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Heart Attacks: Next Generation Testing at LVHN Helps Rule Them In or Out Sooner

High-sensitivity troponin, a telltale sign of heart injury

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Highly Sensitive Troponin

Lehigh Valley Health Network (LVHN) emergency room physicians and cardiologists are using a new test to help them know much more quickly if you’ve had a heart attack not identified by your electrocardiogram (ECG).

Diagnosis time can be cut by hours, potentially shortening time to appropriate treatment. For those whose symptoms are not due to a heart attack, the new test rapidly identifies individuals who can safely be sent home.

Telltale protein

A heart attack damages heart muscle, releasing a type of protein called troponin (trow-puh-nuhn). Troponin is ordinarily present in your blood in extremely low levels. If you are having a heart attack, troponin levels will rapidly rise in your blood and be detected by the new high-sensitivity testing.

The new blood test, in place at all LVHN hospitals, allows doctors to see changes in troponin levels at much lower quantities than with previous testing equipment and much earlier. Rising or falling troponin levels can signal a heart attack from a blocked artery or heart damage due to other causes.

“This test helps the emergency physician achieve greater accuracy in safely discharging patients and appropriate hospitalization of our chest pain patients,” says Richard MacKenzie, MD, LVPG Emergency Medicine and Senior Vice Chair, Emergency and Hospital Medicine, LVHN.

Rapid detection now available

Prior to high-sensitivity testing, a patient had a series of blood tests over three to six hours before doctors could confirm significant changes in troponin levels and evidence of heart injury. Now, with high-sensitivity testing, doctors can detect heart injury in just two to three hours after symptoms begin.

“Because (high-sensitivity testing) detects changes in troponin levels very quickly, we’re able to identify a patient with a high risk, as well as someone who has a low risk for a heart attack,” says cardiologist Bruce Feldman, DO, with LVH Cardiology–1250 Cedar Crest, Lehigh Valley Heart and Vascular Institute. “This is a significant benefit for patients and health care networks.”

Troponin gender differences

Troponin levels differ by gender, with women having lower levels than men.

“When it comes to heart disease, women are different from men in terms or presentation, symptoms, outcomes and treatment strategies,” says cardiologist Amy Ahnert, MD, Director, Women’s Heart and Vascular Program, Lehigh Valley Heart and Vascular Institute. “Here at LVHN, we recognize that there are gender differences when it comes to the diagnosis and treatment of heart disease and this new test will help us in our mission to improve outcomes in women.”

 

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