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Breast Implants Increase Difficulty of Diagnosing Heart Attacks in the ED

July 13th, 2017

Breast implants can make it more difficult for emergency physicians to accurately diagnose heart attacks, a new study reveals.

Research presented at European Heart Rhythm Association (EHRA) Europace Cardiostim 2017 reveals information on how breast implants might impede an electrocardiogram (ECG) and, in some cases, lead to an incorrect diagnosis of acute myocardial infarction.

“Our experience shows that breast implants make it difficult to see the heart with echocardiography because ultrasound cannot penetrate through the implant,” explained lead author Sok-Sithikun Bun, MD, a cardiologist at Princess Grace Hospital, Monaco. “We wanted to find out if implants also disrupt an ECG.”

The study, designed to determine if breast implants are associated with abnormal ECG recordings, involved 48 total participants: 28 women with breast implants and a control group consisting of 20 women of the same age who did not have breast implants. None of the participants had been diagnosed with structural heart disease.

ECGs were performed on all the women and then reviewed by two experienced electrophysiologists who were not given any information about the patients such as age, sex, presence or absence of structural heart disease, or presence or absence of breast implants.

In the control group, the women without breast implants, all ECG results were considered normal by the electrophysiologists, except in a single case tagged by one of the experts as abnormal. That instance represented 5% of those participants.

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For women with breast implants, however, 38% of the ECGs were deemed abnormal by one electrophysiologist and 57% were deemed abnormal by the other.

“The main difference between the two groups of women was the breast implants, so we think the abnormal ECG recordings were false readings due to the implants,” Bun pointed out. He added, “Albeit echocardiography is difficult in women with implants, these measurements indicated that they had normal hearts and no structural heart disease, which suggests that there was no heart problem that could explain the abnormal ECGs.”

Study authors said they wanted to increase awareness of the situation among emergency clinicians.

“When a patient comes to the emergency department with chest pain an ECG is performed to see if they are having a heart attack,” Bun added. “Doctors should be aware that ECG interpretation can be misleading in patients with breast implants. In case of any doubts regarding the diagnosis, blood tests need to be performed depending on the symptoms.”

The researchers not only advised that women with breast implants inform physicians they have them, but also that they should consider having an ECG before undergoing surgery to place the implants.

That way, according to Bun, “The ECG can be kept on file and used for comparison if the patient ever needs another ECG.”

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