Heart Attack Test: Fast Diagnosis With X-Ray Vision

Is it a heart attack or just indigestion? A Harvard study shows of the six million people who went to hospital emergency rooms for chest pain in 2009, only about 20 percent were actually having heart attacks.

Chris Paradowski knows now what he thought was a heart attack was really just a false alarm, but it took several hours in the ER to find out.

Cardiologist Doctor Greg Lanza says, "The primary problem that we wanted to address was the issue of patients coming into the emergency room with chest pain who have to go through significant testing only to find out they never really had coronary disease."

Lanza's team at Washington University is working on a rapid test to get heart attack patients fast treatment, and people without heart disease home fast. The test takes minutes, instead of hours.

The patient would be injected with a solution containing millions of tiny nanoparticles designed to bind to proteins that form blood clots in the coronary artery.

In experimental models, spectral CT scan imaging works like x-ray vision to detect the particles and light up the clot.

It could be the diagnostic imaging tool of the future, separating false alarms like Chris's from the real thing when every second counts.

This heart attack test is still experimental. The research phase of the project is continuing with clinical trials a few years down the road.

This same spectral CT technology is also being tested to provide an early warning for stroke.

RESEARCH SUMMARY

BACKGROUND: Every year, millions of people go to the emergency room with chest pain. In most cases, patients have to be admitted to the hospital to undergo tests to rule out or confirm a heart attack. These tests can be expensive and take up a lot of time. Rather than having an overnight stay at the hospital to make sure the patient is stable, new technology known as the spectral CT could reveal the location of a blood clot in a matter of hours. Researchers at Washington University School of Medicine in St. Louis say they've designed nanoparticles that find clots and make them visible to a new kind of X-ray technology. (SOURCE: Washington University School of Medicine)

ABOUT THE SCAN: When a person suffers a heart attack, the lining of their coronary artery ruptures, and a clot forms to repair it. The same clot also narrows the vessel, blocking the flow of blood. These nanoparticles (which are mixed into a solution that is injected into patients) are able to "see" that clot. Not only that, but the spectral CT scanner is capable of "seeing" metals in color. It uses the full spectrum of the X-ray beam to differentiate objects that would be indistinguishable with a regular CT scanner that sees only black and white. The nanoparticles are targeted to a protein in the blood clot called fibrin. One of the major problems with a traditional CT image is that it shows no difference between the blood clot and the calcium in the plaque, making it unclear if it is a clot that should be treated. However, a spectral CT image actually sees the nanoparticles targeted to fibrin, differentiating it from calcium in the plaque. (SOURCE: Washington University School of Medicine)

APPLICATION: The nanoparticles and spectral CT scanner cannot only confirm a heart attack but also show a clot's exact location. Since the nanoparticles find and stick to fibrin in the vessels, they would allow doctors to see problems that were previously difficult or often even impossible to detect. The spectral CT scanner is still a prototype instrument. Philips Research in Hamburg, Germany developed the technology. The nanoparticles have only been tested in rabbits and other animal models, but early results show success in distinguishing blood clots from calcium interference.

The work was completed with the help of grants from the National Cancer Institute, Bioengineering Research Partnership, American Heart Association, and the National Heart, Lung, and Blood Institute.


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