A new blood test developed by Peter Hwang, a physician at the University of Alberta in Canada, can differentiate between a heart attack and heart strain, facilitating appropriate diagnosis and treatments for patients.
According to the researcher, the existing cardiac troponin blood test, which is the current gold standard for myocardial infarction diagnosis, does not highlight the exact extent of cardiac damage.
Elevated blood levels of the cardiac troponin protein that is found only in the heart are said to indicate heart damage. Hwang found that patients suffering from an actual heart attack had more fragmented troponin compared to those with increased cardiac strain.
Hwang said: “We postulated that when cells die during a heart attack, not only would they release troponin into the bloodstream, but they would also digest the troponin through the action of activated intracellular proteases-enzymes that digest other proteins.”
During a study of 29 patients with elevated troponin levels, it was observed that the degree of proteolytic digestion was more when the severity of heart injury increased. Highest digestion was found in patients with ‘classic heart attack’ and least in those with a strain on the heart.
While further research is required, the physician believes that the new troponin test could direct objective treatment decisions in the case of less clear-cut situations.
He added: “Sometimes the correct answer to the question – is it a heart injury or merely strain? – isn’t always obvious, even with all the clinical information.
“Suppose there is a critically ill patient with an elevated troponin level. Is the patient having a heart attack? Or is the troponin level elevated because the heart is working hard?
“This is a very real diagnostic dilemma faced by doctors treating patients. This test could resolve the challenge.”