Guidance aims to prevent heart attack deaths

Doctors were given new guidance today to ensure they quickly diagnose the cause of chest pain and prevent people dying unnecessarily from heart attacks.

Patients with acute chest pain who are suspected of suffering from certain types of heart attack or angina should be given an electrical test as soon as possible, according to recommendations published by the National Institute for Health and Clinical Excellence (Nice).

But obtaining the results should not delay a patient getting to hospital, the guidelines added.

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In addition, medics should no longer routinely administer oxygen because it could be harmful to people experiencing such heart problems and are advised instead to monitor levels of oxygen in the blood.

Intermittent, stable chest pain should be diagnosed through clinical assessment and, if necessary, testing, Nice said.

Depending on a patient's history and heart risk factors, other causes, such as indigestion or muscular pain, should be ruled out first.

Chest pain accounts for 25 per cent of emergency admissions to hospital and one per cent of visits to GPs, according to Nice, which issues guidance for England and Wales.

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Prof Liam Smeeth, GP and member of the Nice guideline development group, said: "We know that your chance of surviving a heart attack depends on how quickly you get treatment.

"This guideline will help ensure people get the treatment they need when they need it."

Dr Jane Skinner, consultant community cardiologist and clinical adviser to the guideline development group, said: "This guideline will help ensure that people with chest pain of suspected cardiac origin have an accurate and timely diagnosis so that they can receive the treatments we know can make a significant difference to their outcome."

Separate guidance covering treatment of people who suffer a certain type of heart attack known as a non-ST elevation myocardial infarction (NSTEMI) or unstable angina advises doctors to formally assess their risk of future problems using a scoring system.

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The recommendations suggest other tests should also be offered, including putting dye into the arteries to show up narrowed areas and exercising or scanning with sound waves or magnetic resonance imaging to measure how well the heart is working.

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