The disadvantages of modern CT scanners and trained radiologists contribute to thousands of deaths because patients with chest pain cannot get recommended examinations, experts warn.
At least 56,289 patients with angina were denied access to CT scans last year although NHS guidelines say it should be offered to all patients with stable chest pain, according to data from the Royal College of Radiologists (RCR).
The waiting list for this test stretches up to 26 weeks in some parts of the UK and RCR estimates the number of missed scans that actually last year could cause 132,000 patients with symptoms of angina.
Initial scanning can save lives. A major medical trial at the beginning of 2018 found nearly half of deaths and severe heart attacks over the next five years – from 3.9 percent to 2.3 percent.
"That is a significant reduction of a large number of people and, in theory, will save thousands of heart attacks and deaths every year if we have adequate staff and equipment," Dr. Andrew Beale, medical director of RCR said Independent.
With modern equipment, doctors can prioritize patients who need treatment and monitoring and those who need surgical intervention to overcome arterial narrowing. But negative results also have significant benefits.
"With this test I can effectively say & # 39; go home you don't have heart problems & # 39 ;," added Dr. Beale. "It is very big for their mental health, that means there is no hospital and the doctor is following up, and you can stop the treatment if you can say that you will not have a heart attack in the next five years."
Angina, which is caused by reduced blood flow to the heart, is usually not life-threatening but can be a warning sign of heart disease and an increased risk of serious cardiovascular problems.
Since 2016, the Best Institute of Health and Care (Nice), which recommends treatment for the British NHS, says all patients with angina-like symptoms should be offered computed tomography coronary angiography (CTCA).
However, Britain is currently tied to Hungary for CT scanner numbers, with only nine per 100,000 people, and far less than Germany – which has 35 per 100,000 – leading to the bottle neck in the test.
10/10 Subarachnoid vessels
The runner-up image comes from Matt MacGregor Sharp, a PhD student at the University of Southampton. Super high-resolution images show normal arteries on the surface of a mouse brain and are taken with a strong scanning electron microscope. & # 39; Subarachnoid Ship & # 39; this supplies blood to the brain and also acts like a sewer to remove toxic waste products. Matt Macgregor's team tries to show that failure to remove waste by these vessels is one of the underlying causes of vascular dementia.
The researchers took pictures using a technique called & # 39; freezing fractures & # 39; where tissue or cell samples are frozen and then separated to reveal hidden layers in the sample so that they can be studied in great detail.
Sitting on brown brain tissue, the artery appears blue, and the surrounding layer, materia, is displayed in purple.
Matt MacGregor Sharp, University of Southampton, British Heart Foundation – Reflection on Research
2/10 Explosive start
Winner: Endothelial cells coat all blood vessels in the body, forming a barrier between circulating blood and blood vessel walls. They also help protect blood vessels from damage and release important chemical messengers that help control blood pressure.
The winning researcher, Courtney Williams, is a Masters student and PhD candidate at Leeds University. His laboratory is developing new ways to map the growth of new blood vessels in the landscape surrounding them in 3D. Understanding the complex secrets of blood vessel formation can be used to increase the regrowth of blood vessels damaged after a heart attack, and stop the growth of blood vessels when it's counterproductive.
Courtney Williams, University of Leeds, British Heart Foundation – Research Reflections
3/10 A snapshot of platelet production – Reflections on Favorite Research Supporters
This picture from Abdullah Obaid Khan, a PhD student at the University of Birmingham, won supporters' favorites. What looks like a precious gem is actually a platelet that forms inside the bone marrow. Platelets are the smallest blood cells that circulate with a very important role in preventing bleeding. However, they also play a role in the formation of clots, which can cause heart attacks and strokes. Abdullah Obaid Khan and his team are studying rare bleeding disorders.
Abdullah Obaid Khan, University of Birmingham, British Heart Foundation – Reflection on Research
4/10 Web collagen heart – Brief note
This colorful image shows the smallest network of blood vessels in the heart that resembles a web – microvessels. Magenta marks the layer of collagen outside the vessels; while orange marks their inner layer and turns the cell nucleus blue. Dr. Neil Dufton, Imperial College London
Dr. Neil Dufton, Imperial College London, British Heart Foundation – Research Reflections
5/10 Heart to Heart – Short List
This section shows four ventricles (from mice) arranged into a four normal chamber heart shape. Researchers have used fluorescent markers to recognize certain proteins and create images using hundreds of images arranged together. Dr. Elisa Avolio and Dr. Zexu Dang, University of Bristol
Dr. Elisa Avolio and Dr. Zexu Dang, University of Bristol, British Heart Foundation – Research Reflections
6/10 Loving artery – Short list
This image shows the cross section of the arteries and various layers that make up the arterial wall. Professor of Affiliation Silvia Lacchini, University of Glasgow
Silvia Lacchini, University of Glasgow, British Heart Foundation – Reflection on Research
7/10 Oxidative Inkblot – Short list
This color explosion shows one of the causes of cardiovascular disease – an enzyme called NADPH oxidase. Enzymes are considered & # 39; Janus faced & # 39; because it is important in health, as well as disease. This picture shows active enzymes in patients who have high blood pressure. Dr. Livia de Lucca Camargo, Glasgow University
Dr. Livia de Lucca Camargo, University of Glasgow, British Heart Foundation – Reflection on Research
8/10 Neon skeleton – Short List
This picture shows the blood vessel system developing from the zebra embryo two days. The researchers used gene enhancers (switch on-off genes) to activate fluorescent markers in various types of endothelial cells – the important cells lining all blood vessels. All blood vessels turn to the red marker, while the blood vessels also activate the green marker, producing yellow blood vessels and red arteries. Dr. Svanhild Nornes, University of Oxford
Dr. Svanhild Nornes, University of Oxford, British Heart Foundation – Research Reflection
9/10 Calcium Reef – Short list
This image shows calcium in blood vessel cells of people who have high blood pressure and resemble Australia's Great Barrier Reef. Dr. Rheure Alves-Lopes, Glasgow University
Dr. Rheure Alves-Lopes, University of Glasgow, British Heart Foundation – Reflection on Research
10/10 Growing blood vessels – Short list
This picture shows the blood vessels that grow in the rat's retina. With red you can see all the blood vessels and yellow / green You can see the active blood vessels growing (a process called sprouting). PhD candidate Kira Chouliaras, University of Oxford
Kira Chouliaras, University of Oxford, British Heart Foundation – Research Reflection
10/10 Subarachnoid vessels
The runner-up image comes from Matt MacGregor Sharp, a PhD student at the University of Southampton. Super high-resolution images show normal arteries on the surface of a mouse brain and are taken with a strong scanning electron microscope. & # 39; Subarachnoid Ship & # 39; this supplies blood to the brain and also acts like a sewer to remove toxic waste products. Matt Macgregor's team tries to show that failure to remove waste by these vessels is one of the underlying causes of vascular dementia.
The researchers took pictures using a technique called & # 39; freezing fractures & # 39; where tissue or cell samples are frozen and then separated to reveal hidden layers in the sample so that they can be studied in great detail.
Sitting on brown brain tissue, the artery appears blue, and the surrounding layer, materia, is displayed in purple.
Matt MacGregor Sharp, University of Southampton, British Heart Foundation – Reflection on Research
2/10 Explosive start
Winner: Endothelial cells coat all blood vessels in the body, forming a barrier between circulating blood and blood vessel walls. They also help protect blood vessels from damage and release important chemical messengers that help control blood pressure.
The winning researcher, Courtney Williams, is a Masters student and PhD candidate at Leeds University. His laboratory is developing new ways to map the growth of new blood vessels in the landscape surrounding them in 3D. Understanding the complex secrets of blood vessel formation can be used to increase the regrowth of blood vessels damaged after a heart attack, and stop the growth of blood vessels when it's counterproductive.
Courtney Williams, University of Leeds, British Heart Foundation – Research Reflections
3/10 A snapshot of platelet production – Reflections on Favorite Research Supporters
This picture from Abdullah Obaid Khan, a PhD student at the University of Birmingham, won supporters' favorites. What looks like a precious gem is actually a platelet that forms inside the bone marrow. Platelets are the smallest blood cells that circulate with a very important role in preventing bleeding. However, they also play a role in the formation of clots, which can cause heart attacks and strokes. Abdullah Obaid Khan and his team are studying rare bleeding disorders.
Abdullah Obaid Khan, University of Birmingham, British Heart Foundation – Reflection on Research
4/10 Web collagen heart – Brief note
This colorful image shows the smallest network of blood vessels in the heart that resembles a web – microvessels. Magenta marks the layer of collagen outside the vessels; while orange marks their inner layer and turns the cell nucleus blue. Dr. Neil Dufton, Imperial College London
Dr. Neil Dufton, Imperial College London, British Heart Foundation – Research Reflections
5/10 Heart to Heart – Short List
This section shows four ventricles (from mice) arranged into a four normal chamber heart shape. Researchers have used fluorescent markers to recognize certain proteins and create images using hundreds of images arranged together. Dr. Elisa Avolio and Dr. Zexu Dang, University of Bristol
Dr. Elisa Avolio and Dr. Zexu Dang, University of Bristol, British Heart Foundation – Research Reflections
6/10 Loving artery – Short list
This image shows the cross section of the arteries and various layers that make up the arterial wall. Professor of Affiliation Silvia Lacchini, University of Glasgow
Silvia Lacchini, University of Glasgow, British Heart Foundation – Reflection on Research
7/10 Oxidative Inkblot – Short list
This color explosion shows one of the causes of cardiovascular disease – an enzyme called NADPH oxidase. Enzymes are considered & # 39; Janus faced & # 39; because it is important in health, as well as disease. This picture shows active enzymes in patients who have high blood pressure. Dr. Livia de Lucca Camargo, Glasgow University
Dr. Livia de Lucca Camargo, University of Glasgow, British Heart Foundation – Reflection on Research
8/10 Neon skeleton – Short List
This picture shows the blood vessel system developing from the zebra embryo two days. The researchers used gene enhancers (switch on-off genes) to activate fluorescent markers in various types of endothelial cells – the important cells lining all blood vessels. All blood vessels turn to the red marker, while the blood vessels also activate the green marker, producing yellow blood vessels and red arteries. Dr. Svanhild Nornes, University of Oxford
Dr. Svanhild Nornes, University of Oxford, British Heart Foundation – Research Reflection
9/10 Calcium Reef – Short list
This image shows calcium in blood vessel cells of people who have high blood pressure and resemble Australia's Great Barrier Reef. Dr. Rheure Alves-Lopes, Glasgow University
Dr. Rheure Alves-Lopes, University of Glasgow, British Heart Foundation – Reflection on Research
10/10 Growing blood vessels – Short list
This picture shows the blood vessels that grow in the rat's retina. With red you can see all the blood vessels and yellow / green You can see the active blood vessels growing (a process called sprouting). PhD candidate Kira Chouliaras, University of Oxford
Kira Chouliaras, University of Oxford, British Heart Foundation – Research Reflection
Added to this, Dr. Beale said, "only about half" of CT scanners are modern enough to provide an assessment recommended by Nice who can prioritize patients for surgery. There is also the problem of who will interpret this scan when Britain has the lowest number of radiologists per head of the population of any country in Europe, a fact that "Brexit has not helped".
Wales is the region with the largest gap, with 4,854 angina patients who lost their scans, 78 percent of the minimum estimated by RCR, followed by Scotland (73 percent) and Northern Ireland (58 percent).
While the UK is the best player, it is the only country where Nice's recommendations are explicitly applicable, and RCR estimates that 69,865 people were missed on CTCA scans – 37 percent of the total cases of angina.
This is contrary to the repeated budget cuts in government training and raids on the NHS capital budget, which are intended for maintenance and equipment, to finance the construction of everyday cash-strapped hospitals.
Independent it was revealed in October that trust had £ 3 billion, and rose, collateral savings in the most urgent repairs and equipment upgrades that were considered to pose a significant risk to patients.
"It's beyond frustration that we don't have the capacity to provide what should be a routine front-line test for all those who experience chest pain," said Dr. Giles Roditi, president of the British Society of Cardiovascular Imaging, who collected the numbers along with RCR.
"In contrast, in many hospitals it is easier for a runner with clever knees to get magnetic resonance scanning than for a patient on the verge of a heart attack to get CTCA.
"Deadly cases of heart disease have been missed because we were unable to send these scans correctly throughout the UK."
Support free-minded journalism and subscribe to Independent Thoughts
Calls to address the lack of provision of CTCA are supported by the British Heart Foundation and charity medical director Professor Sir Nilesh Samani said: "It is worrying that there is no better access to CT scans in the UK, leaving some patients with heart disease without a life-saving diagnosis.
"Research supported by BHF has shown that when patients with angina symptoms have a CT scan as part of their assessment, they tend to continue to have a heart attack or die."
A spokesman for the Department of Health and Social Care said: "We want patients to receive world-class care in world-class facilities and to ensure the NHS recruits and trains the talented staff needed. We have announced £ 3.9 billion in new capital investments, and our historic long-term plan for the NHS, supported by an additional £ 20.5 billion a year by 2023/24, will put our health services on a long-term sustainable footing.
"The number of clinical radiologists in the UK has risen 29 percent since 2010 but we want to see numbers continue to increase. That is why over the next three years we allow more doctors to specialize in clinical radiology. "
Source link
