. Each year nearly 5 million people in the US will visit and emergency room with the symptoms of a heart attack including chest pains. Each year as many as 8% of heart attack patients will be misdiagnosed and mistakenly sent home. Heart attack and coronary disease are the account for the most deaths of any medical condition for men and women in the US. There are nearly 1.5 million heart attacks each year, 30% of the victims will die. Although many people experiencing heart attacks will die before they reach a hospital, as many as 80% of patients experiencing a heart Attack will enter an emergency room.
Since the symptoms can be a number of common non life threatening conditions doctors may fail to consider the situation critical when the symptoms are atypical in certain patients. The most common symptom for both men and women is chest pain. Other symptoms can include fatigue, pain during rest, shortness of breath, and general weakness. The most common mistakes doctors make are:
Failure to consider a heart attack younger patients. Around 123,000 men between 30 and 45 are diagnosed with an heart attacks every year.
Although heart attacks are common, many doctors fail to consider them in women. Women after menopause, those on hormone replacement are at greater risk for heart attack as are women who use oral contraceptives.
Doctors may over rely on ECGs results, a normal ECG does not rule out an heart attack.
Making a Correct Diagnosis
There are four main diagnostic tests for detecting heart attacks including: ECG, cardiac imaging, serum cardiac markers, and certain inflammatory indicators.
Electrocardiogram. The ECG is the most important and common diagnostic tool, as many as half of patients with the onset of a heart attack will have normal results. According to a study nearly 23% of heart attack misdiagnosis were related to misreading the ECG.
Cardiac Imaging. Imaging the heart with Echo cardiography can reveal abnormal cardiac wall motion, left ventricular dysfunction, ventricular aneurysm, and pericardial effusion. The techniques are very effective in measuring heart stress, a patient with a negative stress test will be discharged to follow-up.
Serum cardiac markers are signs that a heart attack has occurred. These are released from the heart muscle after a heart attack. The rate and timing of the release are diagnostically important.
The most important feature in making a correct diagnosis is understanding a patients history.
The doctor must pay attention to the risk factors especially in women and the elderly. Several risk factors are associated with heart attack and should be assessed in every patient including age, previous heart problems, the timing of the symptoms eg. exercise, smoking, and menopause.