Study could help GPs to better identify warning signs in patients with undiagnosed chest pain

Doctors could better identify the warning signs of a future heart attack or stroke in patients with undiagnosed chest pain, thanks to a new study funded by the British Heart Foundation (BHF) at Keele University.

Each year, up to one million adults in the UK visit their GP because of chest pain. They can be referred for further tests if coronary heart disease is suspected, or the symptoms can be put down to other commonly associated conditions such as a muscular problem or anxiety.

Many of these patients do not get a specific diagnosis but are more likely to have a heart attack or stroke in the future than those without chest pain. Researchers at Keele University have previously found that the number of people who go onto have a heart attack following undiagnosed chest pain were five times greater than the number of patients diagnosed with angina who then go onto have a heart attack.

Now, the BHF has awarded more than £200,000 to researchers for a study that will aim to determine which characteristics predict future heart attacks or stroke in patients who do not get a specific diagnosis for their chest pain.

The team will study a database of anonymized GP consultations from across the UK, linked to hospital information. Researchers will determine 180,000 cases from 2002 onwards where people first visited their GP with chest pain and will then track the medical records of these patients for up to 10 years.

This will identify the shared characteristics of people who have undiagnosed chest pain and then went on to have a heart attack or stroke. The insight could then be used by GPs as warning signs in people with chest pain and could trigger actions such as preventative medication or lifestyle changes.

The two-year research project, in collaboration with researchers from University College London and Queen Mary University of London, will be led by Professor Kelvin Jordan, Professor of Biostatistics at Keele University.

Professor Jordan said:

Chest pain is a common reason for patients to seek help from their GP, but our previous research has shown that most patients do not get a diagnosis within the first six months and generally do not undergo further tests.

With these patients more likely to have a heart attack or stroke in the future, this could be putting lives at risk, so it is important GPs are equipped with knowledge to identify those patients and intervene before a medical emergency.

Our study will allow those at greater risk to be more easily identified, so they can be given medication or further support at an earlier stage."

Dr Subreena Simrick, Senior Research Advisor at the BHF, added:

With more than 100,000 hospital admissions in the UK each year due to heart attacks, and with stroke being the single biggest cause of severe disability in the country, it is vital that we find new ways to prevent their devastating impact.

This UK-wide study could result in GPs having better knowledge of the warning signs in patients with undiagnosed chest pain, allowing them to intervene with treatment or lifestyle advice earlier. This change in practice could prevent many people from suffering a heart attack or stroke every year.

Funding for this research has only been made possible by the generosity of the people who support us, in our aim to beat heartbreak forever."

In Staffordshire alone, around 1,300 people die from coronary heart disease (the leading cause of heart attacks) each year, whilst stroke claims the lives of more than 600 people in the county every year.

In the West Midlands, around 6,000 people die from coronary heart disease each year, whilst stroke claims the lives of almost 3,500 people in the region every year.

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