TUESDAY, March 19, 2002 (HealthDayNews) -- A middle-aged man shows up at a hospital, complaining of fatigue so severe he can't climb a flight of stairs and shortness of breath that has him gasping.
It could be asthma, emphysema or congestive heart failure. How does the doctor on duty make the call?
Until recently, it was a series of tests -- X-rays, electrocardiograms, blood tests -- that took hours to interpret and often meant at least a night in the hospital for the patient.
Now, a simple blood test that takes no more than 15 minutes for results can decide the diagnosis.
According to new research presented today at the American College of Cardiology's annual scientific session in Atlanta, the blood test looks for elevated levels of a hormone called B-type natriuretic peptide (BNP), a sure marker of congestive heart failure.
In a seven-hospital international test involving almost 1,600 patients, the test was more than 80 percent accurate in pinpointing the problem as congestive heart failure, according to lead author Dr. Alan Maisel. He is director of the Coronary Care Unit of Veterans Affairs Health Care System in San Diego.
On top of that, when the test was combined with some other simple markers, such as swollen ankles, the accuracy rate went up to more than 90 percent for determining congestive heart failure, and 98 percent for ruling out other possible causes.
In addition to helping patients get the most appropriate treatment
quickly, the BMP test also has the potential for saving a lot of money by
preventing unneeded hospital admissions, Maisel says. "Making accurate
diagnoses keeps people out of the hospital," he says.
"There are no drawbacks to use of this test," Maisel adds. "It is easy to
use, requires no more than 3 cc [cubic centimeters] of blood and costs in the mid-20 dollars. This should be in every emergency room. If I had a family member in the emergency room with shortness of breath, I would want them to have this test. It is absolutely life-saving."
Congestive heart failure, which occurs when the heart cannot pump enough blood to meet the body's needs, affects an estimated 4.6 million Americans, with 40,000 new cases every year. An elevated level of BNP is a sign of a failing heart because the ventricles, the blood-pumping chambers of the organ, release the hormone as their ability fails.
"Very often, you can't be certain about the cause of the problem, so the patient is admitted to the hospital to run a series of tests -- a chest X-ray, an electrocardiogram, blood tests," says Dr. Charles Francis, a spokesman for the American Heart Association. "It often took a day or two or three to sort things out. This allows you to focus relatively quickly on one cause."
San Diego-based Biosite Inc. markets the test, which is used in more than 300 hospitals in the United States. Maisel sits on the company's cardiovascular advisory board.
What To Do
Anyone who experiences severe shortness of breath and fatigue should seek medical care at once.
To learn more about congestive heart failure, consult the American Heart Association, or the National Heart, Lung, and Blood Institute.
