HST assay offers a way out

It is a sensitive blood test that can determine if a person with heart attack symptoms is really having an episode

March 15, 2015 12:00 am | Updated 08:08 am IST

The gender dimensions of cardiovascular diseases can be quite perplexing.

The risk of CVD in women is often underestimated by doctors while women themselves are seldom aware of their own risk of heart attacks. More confounding can be the atypical manner in which cardiac emergencies present itself in women.

“Women may not typically clutch their chest in severe pain or break into cold sweat when they are having a heart attack. Instead, they may complain of various non-specific symptoms such as backache, extreme fatigue, or jaw discomfort. ECG may not show any changes, leading to delays in diagnosing the heart attack or missing it altogether,” says Tiny Nair, senior consultant cardiologist.

But now, a new and more sensitive blood test - High Sensitive Troponin assay (HST) - can determine , if a person who presents with heart attack symptoms is really having an episode.

Cardiac troponin testing is routinely done whenever a person is suspected of having a heart attack. Troponin is a complex protein bound to the cardiac muscle, which is released into the blood whenever the heart muscle is injured. Elevated troponin levels in blood thus indicate damage to the heart muscles. Higher the level of troponin, the greater the damage.

The standard troponin test used for diagnosing heart attacks currently in hospitals picks up troponin levels in blood, which rises significantly within four to six hours of a heart attack. The new HST assay is so sensitive that it detects even the slightest elevation in troponin levels.

“The cardiology department at many major private hospitals has now shifted to HST assay as it ensures that we do not miss a heart attack. HST assay becomes all the more significant for diagnosing heart attacks in women because the standard test may not detect the slight variations in troponin levels in women, which may have a lot of impact on clinical decisions,” says Dr. Nair.

Cardiologists, however, caution that troponin levels could be elevated even in other conditions such as renal diseases or after an abdominal surgery.

Hence, a positive HST assay is of significance only if the patient has other signs and clinical symptoms of an acute coronary syndrome.

“If a patient comes to the emergency room with chest pain and the clinical signs and ECG readings are not clear, then an HST assay will help in confirming if he is having a heart attack. The test costs between Rs.500-1000,” Dr. Nair says.

(Reporting by C. Maya)

It is a sensitive blood test that can determine clearly, if a person with heart attack symptoms is really having an episode

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