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Heart scan toolkit unveils hidden damage from atypical heart attacks
  • May 6, 2022
  • Latest News

Heart imaging techniques already available on the NHS could be used to improve detection of underlying heart disease and treatment following a common but often overlooked type of heart attack, according to research we've funded and published today in Circulation.

Currently, there are no guidelines for doctors on how to best assess or treat a patient after they are diagnosed with a type 2 heart attack. This means that most people who have one do not undergo further testing or treatment, with only around a third of patients surviving after five years.

Drastically increase diagnosis
Now, in the first study testing heart imaging techniques in type 2 heart attack patients, scientists at the University of Edinburgh have found that performing a combination of heart scans on patients who are suspected of having a type 2 heart attack can drastically increase diagnosis of underlying heart conditions. This opens the door to immediate treatments and could prevent a second heart attack.

A ‘traditional’ (or type 1) heart attack happens when one of the small arteries supplying blood to the heart becomes blocked, which starves the heart muscle of oxygen and nutrients, and leads to damage. However, a type 2 heart attack – which accounts for 15 per cent of patients with damage to their heart 2 - does not involve a blockage. It occurs with illnesses that put the body under stress and when the oxygen being breathed in cannot meet the demands of the heart. This puts the heart under additional strain and can happen with conditions such as pneumonia, heart rhythm problems, or very low blood pressure.

Researchers looked at the results of different heart scans of 100 people who had been diagnosed with a type 2 heart attack using an ECG and a troponin blood test. They used an angiogram to look at the blood vessels in the heart, and echocardiogram and heart MRI scans to look at the structure and function of the heart in real-time.

Easily treatable
Two thirds of patients were found to have coronary artery disease, and one third were found to have heart muscle weakness, both conditions that are easily treatable. Over 50 patients were given a new diagnosis, and seven were re-diagnosed as having had a ‘traditional’ heart attack.

The team already plan to start a clinical trial to  further look at patient outcomes after performing a combination of angiogram and echocardiogram scans in patients with type 2 heart attacks with hopes of expanding to an international trial.

Dr Andrew Chapman, BHF-funded researcher at the University of Edinburgh who led the study, said: “We’ve provided much-needed evidence that heart imaging tools already available in hospitals can spot hidden heart conditions in people with this type of heart attack that we now know is common but often overlooked. These conditions can be easily treated once identified and we hope these results, combined with our upcoming clinical trial, will bring us closer to the first guidelines for diagnosis and treatment of a type 2 heart attack.”

Hope for new guidelines
Professor Sir Nilesh Samani, our Medical Director, said: “Thankfully, more people than ever are surviving heart attacks. However, survival rates for a type 2 heart attack are much lower than a traditional heart attack. We urgently need new guidance for doctors on how to assess and treat these patients, which this research provides. This is a vital step towards helping people make a better recovery and reduce their risk of a second heart attack, heart failure and even death.”

We have launched a campaign calling for the public’s support to power science that could lead to new treatments and cures for all heart and circulatory diseases.