Misdiagnosis of Heart Attack

What is a heart attack? A heart attack occurs when the supply of blood to the heart is suddenly blocked. The two main types of heart attack are an ST segment elevation myocardial infarction (“STEMI”) and a Non-ST-Elevation Myocardial Infarction (“NSTEMI”). STEMI occurs when there’s a total blockage. NSTEMI, which is more common, is a partial blockage.

A heart attack can result in serious damage to the heart muscle. The longer a heart attack is left undiagnosed, the more the heart muscle can be irreversibly damaged which can be fatal. Early diagnosis and treatment is therefore critical to making a good recovery and outcome for a patient.

Symptoms

The symptoms that can indicate a heart attack are:

• Chest pain
• Pain that may spread to your left or right arm that may spread to your neck, jaw, back or stomach
• Shortness of breath
• Feeling or being sick
• Sweating
• Feeling weak or lightheaded, or both
• An overwhelming feeling of anxiety that similar to a panic attack
• Excessive coughing or wheezing

Misdiagnosis

Heart attacks are frequently misdiagnosed, and more so in women - 50% of women are more likely than men to have an initial diagnosis, often indigestion, which is different from their final diagnosis.

More specifically, women who had a final diagnosis of STEMI had a 59% greater risk of misdiagnosis compared with men, while woman who had a final diagnosis of NSTEMI had a 41% greater risk of a misdiagnosis when compared with men.

Women who were given an initial correct diagnosis of heart attack had a 2.5% chance of dying within 30 days. However, if they were initially misdiagnosed, then their risk of death increased by 70%, to 4.2%.

Complications

A heart attack is a medical emergency, and therefore if a heart attack is suspected an electrocardiogram (ECG) should be performed and the patient admitted to hospital immediately. Pain relief and aspirin should be offered as soon as possible.

Upon admission, a further ECG should be carried out and a sample of blood taken to test for specific proteins. Damage to the heart from a heart attack causes certain proteins to slowly leak into the blood. If doctors suspect a patient has had had a heart attack, a sample of blood will be taken so it can be tested for these heart proteins (known as cardiac markers). The most common protein measurement is called cardiac troponin. The troponin level can help in diagnosing the type of heart attack that has occurred.

Unfortunately, too often patients are misdiagnosed with other problems, and these tests are not carried out for some time. These delays in testing can cause the patient to suffer potential avoidable and irreparable damage to the heart. This can lead to further complications, including: arrhythmia (abnormal heartbeat), heart failure, cardiogenic shock and heart rupture. These complications can be both life impacting and life limiting. Invasive surgery may also be necessary. With timely diagnosis and treatment however, many people only require a short hospital stay and make a full recovery following a heart attack with little or no impact to their life expectancy.

Lanyon Bowdler’s award winning clinical negligence team includes members of the Law Society’s Clinical Negligence Panel and AvMA panel members. The team has experience of dealing with cases where a heart attack has been misdiagnosed. If you have concerns regarding diagnosis and treatment of a heart attack our team is happy to discuss the matter with you and guide you through the process sensitively.