Or perhaps your mailbox is empty, barren as a desert, as you stare in there forlornly.

In that case you might feel pangs around your heart region, something like a case of small or large case of heart-break. But is heartbreak just a colourful expression, or something physiological?

The good folk at the New England Journal of Medicine suggest that there is in fact be a physiological foundation to heartbreak.

A condition known as Takotsubo Cardiomyopathy can occur when a stressful and emotional event ­occurs in your life, such as losing an important person or not receiving a Valentine’s Day card from a spunk.

The transmission mechanism is illustrated in the below image:

When someone presents to a doctor with Takotsubo Cardiomyopathy it tends to mimic the symptoms of acute coronary syndrome. Argggh!

The good news is that if you are suffering from Takotsubo Cardiomyopathy, it’s easily treatable by a doctor, and there don’t appear to be any lasting effects, to the heart at least.

Of course, if you do happen to be emotionally heartbroken and have symptoms that you feel are problematic, don’t assume it’s Takotsubo Cardiomyopathy. Consult a doctor straight away to be sure.

If you do end up getting checked out, it’s possible a Troponin test is used to determine if there’s anything serious going on in the heart region, as this gentleman discovered.

Sadly, on the emotional heartbreak front, we have not discovered any immediate cure. To conclude matters on this topic, here’s an insight into lost love and heart-break from Billy Ray Cyrus:

‘I’m so miserable without you, it’s almost as though you’re here.’

Enjoy your Valentine’s Day everybody. Please send all Valentine’s cards to the Editor, c/- PAA, 123 Heartbreak La, Sadsville.

The post Happy Valentine’s Day: is there such a thing as heartbreak? first appeared on Know Pathology Know Healthcare.

The South Australian firefighter was the fittest he had ever been so when he felt what he called a “dull pain in his arm” at home one night, a heart attack was the last thing on his mind.

After ignoring his symptoms for two days, he finally visited his GP who performed a troponin blood test which rapidly detects heart attack risk by measuring levels of the protein troponin, released by damaged heart cells, in the blood.

The test was sent to a pathology lab for analysis and within an hour, the lab’s pathologist reported the results that revealed that Greville was about to have a heart attack. An ambulance was sent to his home and he was rushed to Lyell McEwin Hospital for urgent intervention. The hospital cardiologist identified three blocked arteries in his heart and performed emergency surgery.

Greville has made a full recovery since the incident and is extremely grateful to the pathology staff for their speedy work: “If it wasn’t for the rapid test results, I would have had a cardiac arrest at home and I might not be around to spend Christmas with my wife.”

Greville’s hometown Mallala is situated in the Adelaide Plains Council which has one of the highest rates of heart attack deaths in South Australia according to the Heart Foundation.

For people like Greville who live far from Adelaide’s hospitals, troponin blood tests can reduce heart attack deaths by ensuring a rapid diagnosis, and decreasing time spent in emergency departments.

Results are obtained in just 20 minutes and can save patients from having further tests and cut costs and hospital time.

The impact of this test was examined in the CIE Value Of Pathology report, which can be viewed here.

Thanks to the effectiveness of pathology many Australians like Greville are now living with greater understanding about their health status.

Watch the Channel 9 story on Greville and the pathology team below…

The post “A Troponin test saved me from the heart attack I didn’t know I was having” first appeared on Know Pathology Know Healthcare.

The study, published in the Journal of the American College of Cardiology, and funded by the British Heart Foundation, shows the troponin test – currently used to help diagnose a heart attack – can also predict a patient’s risk of heart disease and death.

Coronary heart disease – the cause of heart attacks – is Australia’s single biggest killer, accounting for one death every 26 minutes. When heart muscle is damaged it leaks a protein called troponin in to the blood stream. Patients suspected of suffering a heart attack will often be given a troponin test to aide diagnosis, but the test has not previously been used to predict heart attack risk.

The study looked at 3,000 men with high cholesterol but no history of heart disease. Using a high-sensitivity test, the research team found that changes in troponin levels accurately predicted the risk of a person suffering a heart attack or dying of coronary heart disease up to 15 years later.

The team also found that by measuring troponin levels in the blood they could tell which patients were responding to the statins used to treat their high cholesterol.

They noted that taking a statin reduced troponin levels. Those whose troponin levels decreased the most had a five times lower risk of heart attack or death from coronary heart disease compared with those who troponin levels were unchanged or increased. Therefore, a decrease in troponin could indicate a patient’s treatment is working, whilst an increase could prompt a change in treatment strategy.

Professor Sir Nilesh Samani, Medical Director at the British Heart Foundation, said: “The hope from this new research is that we may be able to use this simple test earlier on to identify people at higher risk of suffering from a heart attack. Those found to be at higher risk could have their preventative treatments intensified.

“Before the findings from this research can be clinically applied, the usefulness of measuring troponin findings need to be demonstrated in a wider group of patients. If this confirms its value, the test could easily be administered by GPs during standard check-ups, and could ultimately save lives.”

You can read the full study here. 

The post The commonly used blood test that could save even more lives first appeared on Know Pathology Know Healthcare.

Heart disease is the number one killer of Australian women – claiming the lives of twenty-four women a day – and is responsible for one in eight premature deaths in women.

Pathology has an important role in helping keep women’s hearts healthy and in diagnosing and treating women with heart conditions.

Cardiology specialist Associate Professor Clara Chow told us; “A range of tests are used to assess women’s heart disease risk and tests also help in monitoring progress and treatment targets.”

One in three Australian adult women has high cholesterol and a worrying ninety percent of these women are not aware of their condition. What’s more, only one in nine women aged 30-65 know that high cholesterol is a risk factor for heart disease. This is why the Heart Foundation is so concerned about raising awareness of heart health among women and encouraging them to learn more about risk factors and to talk to their doctor about testing.

So, what tests are used in a regular heart health check?

A/Prof Chow said; “A full lipid profile is key, i.e; not just total cholesterol, but LDL-cholesterol, HDL cholesterol, triglycerides and the ratio of these. It’s important to also assess for diabetes with screening tests including glucose and HbA1C as well as looking at renal function – in terms of creatinine and eGFR.”

The new approach to lipids testing which no longer requires patients to fast for eight hours before having their blood taken for testing is good news for heart health as it makes testing easier for patients.

In terms of diagnosis and treatment, pathology is vital. A/Prof Chow said, “Pathology tests help in assessing whether there is an acute problem. Sensitive cardiac troponin tests, for example, are often used to diagnose whether chest pain is part of an acute coronary syndrome.”

High sensitivity troponin is effective in diagnosing heart attacks in women that might otherwise have been missed. This test is used extensively in Australian hospitals for people who present to emergency departments with chest pain.

The test measures the level of the protein troponin in the patient’s blood which is released by the heart muscle during a heart attack.

Fifty Australian women have a heart attack each day, and eleven of these will be fatal. Women often experience the lesser known symptoms such as pain in the jaw, shoulder, neck and back. When a woman experiences a heart attack, the level of troponin in her blood may be lower than the typical range for a man which is why a high sensitivity test is helpful in detecting it.

Diagnosing a heart attack quickly means patients can be given the best treatment.

According to the recent Economic Value of Pathology report, troponin testing can help to manage down the $167 million a year spent on people who present to emergency departments with chest pain.

A/Prof Chow said pathology allows doctors to find out more about related conditions as causes for heart problems:

“In patients with known coronary heart disease or those with heart failure there may be other tests that can help. These vary between patients but one example would be for a female patient with a new presentation of heart failure, we might do thyroid function tests and iron studies as these may help us understand what could be causing her condition.”

The Heart Foundation has succeeded in raising women’s awareness of heart disease as the leading cause of death in women, from 20% in 2008 to 35% in 2015. They are now striving to spread the message even further and reach a target of 50% by December 2017.

Learn more about the campaign here

Associate Professor Clara Chow is Associate Professor with the Faculty of Medicine University of Sydney, Director of the Cardiovascular division of The George Institute, and Program Director, Community Based Cardiac Services, Westmead Hospital.

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Pathology testing saves lives and money according to a new report released today. Half the Australian population had a pathology test in the last 12 months. According to the report a third of the rise in tests requests is from doctors as they seek to prevent or minimise the impact of disease.

Pathology testing is central to controlling important, growing chronic diseases including diabetes. Managing diabetes without pathology has been compared to trying to drive a car without a steering wheel.

One in two GP visits involves a request for pathology tests. 60% of GP referrals for pathology relate to preventative health strategies and management of chronic illness. The report notes that 32% of the increase in clinical demand for pathology is due to preventative health treatments.

The Economic Value of Pathology is a meta-analysis conducted by the Centre for International Economics that examines three key health areas: diabetes, heart attack and colorectal cancer. Pathology is practiced in laboratories and is a largely unseen area of healthcare. The report was commissioned by Pathology Awareness Australia to quantify the value of investment in pathology.

70% of medical decisions rely on information from pathology testing and all cancer diagnosis is made by pathology investigations.

Pathology includes tests on blood, urine, swabs and biopsies, and provides detailed information to doctors. The report says Australia has among the highest quality pathology in the world and results produced by a workforce of 35,000 underpin the standards of overall healthcare.

Enhanced diagnostic technologies combined with the ageing population and an increasing focus on prevention, has spurred growth. Men over 75 in particular now access more testing for chronic disease management and preventative health strategies.

The total cost of delivering 500 million pathology tests per year across the community and in hospitals is estimated at 3 per cent of total health spending.

Report author Sarina Lacey from the Centre for International Economics says the findings highlight the need to invest appropriately in pathology:

“Pathology offers tremendous return on investment. With so many people with and projected to develop diabetes and other chronic conditions, it’s important to make smart, cost-effective decisions before health problems become expensive to manage. Getting health expenditure in the right areas makes good economic sense and pathology can make this happen.”

Pathology testing a defence against ballooning diabetes treatment costs

Diabetes related testing accounts for 10.5% of the growth in requesting from general practice and 6% of all GP orders for pathology.

1.7 million Australians have diabetes and this is forecast to rise to 3.5 million within 17 years. Diabetes complications account for 14% of preventable hospitalisations, 67% of Australian adults with diabetes have high blood pressure, and 68% die of heart disease or stroke.

Pathology tests are integral to diabetes prevention programs. The report notes that Type 2 diabetes prevention programs can save between $2,600 and $5,300 per life year.

The Haemoglobin A1c (HbA1c) blood test indicates the level of long-term blood sugar control. Proactive action on regular HbA1c results can help keep levels normal in people with diabetes. A small sustained decrease can reduce the cumulative incidence over five years in: end stage kidney disease by 40%; amputation by 21%; advanced eye disease by 43%; and heart attack by 16%.

Pathology Awareness Australia Ambassador A/Prof Graham Jones is a Pathologist at Sydney’s St Vincent’s Hospital. He specialises in testing for diabetes and says,

“Pathology underpins most of healthcare – you can’t do without it. Diabetes is defined by pathology tests – we have no other tools to see if we’re winning against the condition. Trying to manage diabetes without pathology is like trying to drive a car without a steering wheel!”

Sturt Eastwood, CEO of Diabetes NSW says,

“Diabetes is a significant, expensive problem that continues to grow at an alarming rate. Helping people prevent diabetes or reduce their complications is a win for the individuals involved and for the economy as a whole. Pathology testing is a vital part of diabetes management.”

$167 million per year can be managed down by ruling out heart attacks in Emergency Departments

Patients with chest pain account for approximately 10% of Emergency Department (ED) presentations. Approximately 1 in 5 cases will be for heart attack with the remainder for more benign conditions. At current ED attendance rates, $167 million per year is required to triage chest pain patients prior to hospital admission or direct discharge.

The Troponin blood test is an essential tool to diagnose and rule out heart attack. Recent advances in Troponin tests have allowed costs to be partially managed down. Newer Troponin tests may allow 40% of chest pain patients to be discharged earlier if used to their full potential.

Smart testing matches patients with the best therapies

Personalised medicine has revolutionised cancer care, and is only possible because of pathology. Pathology can now test the genetic characteristics of the cancer to determine if a treatment will work on a patient.

Smart tests can match the patient with the appropriate drug therapy. The report notes that the KRAS and RAS mutation gene tests have been found to provide net cost savings to the Australian Government by ruling out treatment for patients that won’t respond well, and reducing harm and improving outcomes for patients that will.

This has underpinned dramatic improvements in survival and reductions in deaths from colorectal cancer over the past decade, with the 5–year survival rate for metastatic colorectal cancer having risen dramatically up to 67 per cent.

Download the full Value of Pathology report or an infographic including key pathology facts.

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