Faster heart attack assessment in the ambulance

21 november 2025

Heart attacks are a major cause of emergency calls in the Netherlands. In his PhD research at the Catharina Hospital, Jesse Demandt studied new methods to assess the risk of a heart attack already in the ambulance. His work shows that simple risk scores combined with a small blood test can safely identify patients with low or high risk. He successfully defended his PhD dissertation on November 21 at the Department of Biomedical Engineering.

Photo by Jarno Verhoef, Catharina Hospital

Every year, around 200,000 people in the Netherlands call an ambulance because of chest pain, making it the most common reason for emergency transport. Ambulance staff must quickly determine whether a patient is having a heart attack. If they are, the patient is taken immediately to a hospital where emergency stent treatment is available. This ensures treatment starts as soon as possible and hospital stays are minimized.

However, most patients do not show clear signs of a heart attack on the ECG. Some may still have a so-called 鈥榮ilent鈥� heart attack, which is harder to detect. In practice, these patients are usually taken to a hospital for further testing, which can take hours. For most, no life-threatening condition is found, and they go home the same day. Some high-risk patients, however, first end up in hospitals without stent facilities, delaying treatment by days.

Exploring risk assessment in the ambulance

In recent years, new tools have been developed to estimate the risk of a silent heart attack in the ambulance. Demandt studied which tools are most suitable, how low-risk patients can be safely left at home, and how high-risk patients can get faster, more effective treatment.

Cover of the thesis by Jesse Demandt

His research found that the preHEART and HEART score, combined with a finger-prick blood test, are the most effective ways to assess risk.

Key findings

Low-risk patients can safely stay home or be referred to their general practitioner, avoiding long waits in the emergency department.
High-risk patients can be taken directly to hospitals with stent treatment, reducing time to treatment and hospital stay.
Patients need fewer invasive tests, and the workload on ambulance staff is reduced.
Implementing this risk assessment could save the Dutch healthcare system millions of euros per year.

According to Demandt, prehospital risk stratification in the ambulance is safe, effective, and cost-saving.

Impact for the future

This research shows that patients with chest pain can receive faster, more tailored care, with fewer unnecessary hospital visits. By applying the preHEART and HEART scores in the ambulance, care is not only more efficient but also safer for patients.

Demandt鈥檚 research received widespread recognition. He won two awards at the Catharina Science Night (), and his work was highlighted in national media ().