A blood test to detect heart attacks

Can you recognize the signs of a heart attack? Although heart attacks can happen suddenly accompanied by the unmistakable chest pain – basically the attacks portrayed in films – most heart attacks start slowly and mildly so that they may be ignored, taken for granted, or misdiagnosed. According to the Medline Medical Encyclopedia:

A heart attack or acute myocardial infarction (MI) occurs when one of the arteries that supplies the heart muscle becomes blocked. Blockage may be caused by spasm of the artery or by atherosclerosis with acute clot formation. The blockage results in damaged tissue and a permanent loss of contraction of this portion of the heart muscle.

Each year, more than 1 million people in the US suffer from heart attacks and about half of these die. Studies have shown that the sooner medical help is given to those who suffered from heart attack, the better are the chances of survival and recovery.

Symptoms of heart attacks can sometimes be so innocuous and misleading and can include (in the absence of chest pains) numbness and pain in the upper part of the body (arms, shoulders, neck), dizziness, vomiting, shortness of breath and sweating. Symptoms can vary between men and women and from one individual to another.

Researchers at the Massachusetts General Hospital have developed a method to detect a heart attack soon after it occurs. The method is a blood test that detects changes in several small molecules (metabolites) present in a patient’s blood soon after a heart attack occurs.

The researchers report:

“We identified changes in circulating levels of metabolites participating in pyrimidine metabolism, the tricarboxylic acid cycle and its upstream contributors, and the pentose phosphate pathway. Alterations in levels of multiple metabolites were detected as early as 10 minutes after PMI in an initial derivation group and were validated in a second, independent group of PMI patients. A PMI-derived metabolic signature consisting of aconitic acid, hypoxanthine, trimethylamine N-oxide, and threonine differentiated patients with SMI from those undergoing diagnostic coronary angiography with high accuracy, and coronary sinus sampling distinguished cardiac-derived from peripheral metabolic changes.”

There are changes in the metabolite profiles soon after a heart attack that are indicative of heart injury and this is what the blood test is detecting. There are many way to diagnose a heart attack but most of these take time. This new test can aid health care providers in rapid diagnosis of heart attacks, provide rapid treatment and prevent subsequent attacks.

The new blood test is a product of a new field of research called metabolomics which focuses on chemical fingerprints of cellular and physiological processes.