Post-surgery heart attack: '85% undetected due to lack of symptoms'
According to a study published in the journal Anesthesiology, over 8 million adults worldwide have injuries or heart attacks after surgery each year, with 10% dying within 30 days. Now, researchers say 85% of these heart attacks or injuries may be missed due to lack of symptoms. However, they suggest this could be resolved with a simple blood test following surgery.
Some of the most common signs of a heart attack include chest discomfort, pain in other areas of the upper body - including the back, neck or jaw - shortness of breath, or feeling lightheaded or experiencing nausea.
However, not everyone experiences these warning signs.
The latest study, led by Dr. PJ Devereaux, head of cardiology at the Juravinski Hospital and Cancer Centre in Ontario, Canada, found that only 15% of patients who have post-surgery heart attacks experience "traditional symptoms."
Dr. Devereaux explains:
"Most surgical patients who suffer a heart attack or injury will do so within the first 48 hours after surgery. During this time, most of these patients are typically taking pain medications, which can mask the symptoms of a serious heart injury."
He and his team suggest that a new diagnosis, called Myocardial Injury after Noncardiac Surgery (MINS), would be helpful for doctors because it includes a broader definition of the traditional one currently used to diagnose heart attacks.
They say using the traditional definition of a heart attack would result in 50% of serious post-surgery heart attacks or injuries going undetected, which would affect patient survival chances.
Measuring troponin levels to detect heart injury
The team assessed over 15,000 patients older than 45 during the first 3 days following non-cardiac surgery. All of these patients had a simple blood test measuring troponin - a protein released into the blood when the heart is injured.
The telltale signs of heart attack, such as chest pain, were only present in 15% of the patients who experienced a heart attack. Measuring troponin could alert physicians to heart injury.
Any patients with elevated troponin levels were given an electrocardiogram to evaluate damage to the heart.
After determining which patients had in fact suffered post-surgery heart attacks or injury, the researchers found that only 15% of them experienced chest pain or other heart attack symptoms.
Additionally, the team discovered that without monitoring troponin levels, 85% of the patients who suffered heart attacks or injuries would have gone undetected.
Another finding from the study revealed that of all post-surgery complications, heart attack or injury is the most common reason for patient death within 30 days of the surgery.
Of the patients who suffer these heart attacks, 10% will die within 30 days, the team notes.
In an accompanying editorial, Karsten Bartels, assistant professor at the University of Colorado School of Medicine in Denver, writes:
"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."
The AHA say it is important to know the signs of a heart attack but caution that even if unsure, individuals should have their symptoms checked out or call an emergency response number immediately, as minutes matter when it comes to heart attacks.
Medical News Today recently reported on a study that suggested heart attack mortality is higher for patients at night and weekends.
Written by Marie Ellis
Copyright: Medical News Today
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