Cooler weather could cause risk of weaker blood flow: Doctors

TAIPEI, Taiwan - The recent cooler weather may pose an increased risk of diminished blood flow and heart attacks in some people, and physicians on Friday advised citizens to be more careful. If chest pains occur, patients should visit emergency rooms promptly to minimise risks to their health, doctors said.

Evangelos Giannitsis from Heidelberg University Hospital pointed out that every 30 minutes of delay between symptoms and treatment increases the relative risk of death within one year by 7.5 per cent. According to the latest study by the Asian Conference for Emergency Medicine (ACEM), the new highly sensitive cardiac troponin T test takes only one hour to identify or eliminate heart attack or acute myocardial infarction (AMI) risks among patients with acute chest pains in order for them to receive timely treatments.

A fast and precise diagnosis reduces uncertainty and anxiety for patients, said Taiwan Society of Emergency Medicine Acting Director Tzong-Luen Wang.

Optimization of the diagnosis process also improves ER efficiency as well as doctor-patient relationships, he said, while suggesting that medical institutions enhance the quality of their emergency service using this approach.

Cardiovascular Patients Should Take Chest Pain Seriously

Diagnosing AMI in the ER is critical, and cardiac troponin T checks are precise, Wang stated.

The latest statistics from the Ministry of Health and Welfare indicate that heart disease is the second-most common cause of death in Taiwan, especially due to AMI. "Chest pains often happen along with acute myocardial infarction," says Wang. "Patients with a history of cardiovascular disease, when they experience acute chest pains, should visit the ER within 90 minutes to identify potential myocardial infarction risks for proper treatments."

"Besides going to hospitals as soon as possible," Wang continued, "a fast and precise diagnosis is key to treating heart attacks as well, but it is very challenging to ER physicians. Guidelines for the diagnosis process and treatment strategies are now available for myocardial infarction."

Four Criteria to Diagnose AMI

To identify AMI patients more precisely, the universal guidelines for identifying AMI suggests that the diagnosis process should meet at least two of the following four criteria: 20 minutes of continuous chest pains cause by reduced blood flow for 20 minutes, electrocardiogram checks within 10 minutes after arrival, cardiac troponin T checks and advanced cardiac imagery checks.

The diagnosis process in Taiwan includes the use of electrocardiograms and cardiac troponin T checks. The latter can more precisely rule out the possibility of unstable angina and identify heart attacks in time, doctors said.

AMI Diagnosis Within One Hour: Latest Study

At the eighth ACEM currently taking place in Taiwan, Giannitsis from Heidelberg University Hospital revealed that cardiac troponin blood tests often result in precise and timely outcomes. "Highly-sensitive" cardiac troponin T tests with advanced technologies are now available. Research from TRAPID-AMI concludes that, compared to six hours required in traditional blood tests, it only takes one hour now to decide whether 75 per cent of patients with acute chest pains will experience AMI."

"When we can minimise time with cardiac troponin T tests," said Giannitsis, "we can eliminate or confirm AMI risks faster, which reduce anxiety to patients and speed up the diagnosis process for ER physicians. Since 2011, the European Society of Cadiology (ESC) has included cardiac troponin T tests in its AMI diagnosis guidelines. ESC's annual conference this September also endorsed the one-hour blood tests and suggested enhancing diagnosis efficiency with this practice."