Radiation exposure high in patients presenting to the ER with acute MI

American Heart Association Scientific Sessions 2009

Patients admitted to the hospital with an acute MI are on average exposed to 17 mSv per visit— the equivalent of 850 chest radiographs, according to data presented today.

“Thus far, procedures involving ionizing radiation have only been considered in isolation and we believe a more appropriate way of thinking about this is to consider the accumulative effective radiation dose for a given diagnosis — this may effect change,” Prashant Kaul, MD, fellow in cardiovascular medicine at Duke University Medical Center in North Carolina, said during a presentation.

Kaul and colleagues assessed the total number of chest radiograph, CT chest, CT body, CT head, nuclear rest/stress perfusion, nuclear MUGA, nuclear ventilation/perfusion scan and cardiac catheterization procedures in 21,705 men and 14,002 women admitted for an acute MI at one of 55 hospitals participating in the University Health System Consortium.

Overall 248,822 ionizing radiation procedures were performed on the study cohort; an average of seven procedures per patient. The average cumulative effective dose was 17.13 mSv per patient, per hospital visit.

Eighty-six percent of patients had a chest X-ray, 50% had catheter procedures, 26% underwent CT scans and 21% had a head CT performed.

The researchers reported several limitations to the study. The reported cumulative radiation dose per patient is an estimate and not an actual measurement. In addition, tests assessed were those only used to assess MIs, yet physicians may utilize other types of tests.

“Further research is needed to understand the indications of a noninvasive test involving ionized radiation during acute MI care. Further efforts should be directed towards reducing total exposure dose by the admitting diagnosis and also towards methods potentially trying to assess real time radiation exposure during clinical care,” Kaul concluded. – by Jennifer Southall

For more information:

Kaul P. #998. Presented at: the American Heart Association 2009 Scientific Sessions; Nov. 14-18; Orlando, Fla.