| Today's topic is failure to diagnose heart attacks. | | | | The third time it happened again. He came back |
| What are they and why are they important? The | | | | to the office made the complaints. The doctor |
| failure to recognize a heart attack has significant, | | | | said not to worry about it, you're fine. A few |
| dramatic implications for the patient. If a heart | | | | days after the last visit to the cardiologist, the |
| attack occurs, it can kill off a good portion of | | | | patient developed severe chest pain and difficulty |
| your heart. And if it is not recognized either | | | | breathing. He called an ambulance and was rushed |
| immediately before it happens or at the time it's | | | | to his local emergency room, which was exactly |
| happening, the result could be devastating. | | | | the place where he had been taken to earlier, a |
| Let me tell you about a case I recently handled | | | | few months earlier, to be fully evaluated. Once |
| involving a young man and a failure to diagnose a | | | | the doctors hooked him up to all the monitors in |
| heart attack. The patient developed chest pain | | | | the emergency room, they recognized he was |
| and went to his local emergency room. While in | | | | having a massive heart attack and by that point |
| the emergency room they hooked him up to a | | | | there was very little they could do to save a |
| cardiac monitor, and they drew his blood and did | | | | good part of his heart. |
| all sorts of tests. | | | | It turns out over the next few days an additional |
| They realized that they needed more time in | | | | testing revealed that the patient had three |
| order to properly evaluate to see whether or not | | | | arteries, three major coronary arteries that were |
| he was, in fact, having a heart attack. The | | | | severely blocked. He had three blockages. And |
| hospital was so concerned that they decided to | | | | had this been recognized three or four months |
| admit him to the hospital to run more tests. They | | | | earlier, the patient could have had an elective triple |
| were going to have him do a stress test. They | | | | bypass surgery, which would have prevented |
| were going to get an echocardiogram, which is like | | | | what's knows as ischemia, a cutoff or a lack of |
| a sonogram of the heart. They were going to | | | | blood flow to the heart, what caused him to have |
| draw blood on a regular basis to see whether or | | | | this massive heart attack. |
| not certain enzyme levels were rising, indicate | | | | A majority of his heart was killed off, as a result |
| that he might have a heart attack. | | | | of the lack of blood flow to the heart. And |
| So what went wrong with this patient's care? It | | | | because of that this patient suffered every |
| wasn't the tests that were ordered. All of those | | | | complication known to mankind. So much so, that |
| testes were appropriate and it was good medical | | | | he ultimately was told that he needed to have a |
| practice to do that. The problem arose when the | | | | heart transplant. |
| doctors were interpreting those particular tests. | | | | This patient, unfortunately, is physically incapable |
| They were interpreted incorrectly. In fact, the | | | | of doing any type of activity. He gets tired just |
| computers were reading abnormalities in these | | | | from walking across the room. He needs |
| particular tests, but the doctors who were looking | | | | assistance to do all types of daily activities. And |
| at them blew it off and said not a big deal. That's | | | | it's tragic because when we went to investigate |
| artifact. That's insignificant. We don't care about | | | | and looked back at those medical records, we |
| that. The patient is normal. Everything is fine. | | | | had doctors and experts in cardiology look at |
| He followed up with his cardiologist a few weeks | | | | those diagnostic tests and they told us that these |
| later and he told him he was still having some | | | | were clearly abnormal. And even the computer |
| chest pain. The cardiologist never bothered to get | | | | confirmed that they were abnormal, and the |
| the testing that was done at the hospital and | | | | doctors should have recognized this. This was |
| based upon his own testing realized that the | | | | totally preventable. He could have had elective |
| patient was just fine. He told the patient to come | | | | surgery, which would have prevented the heart |
| back in a month. We'll check you again. | | | | attack and he would have been just fine. |
| The next month the patient returned, as directed, | | | | Unfortunately, for this young man and his family |
| and again, he had the same time of complaints. | | | | he wasn't. |
| You know, I have chest pain. I'm feeling | | | | That's it for today's topic on heart attacks and |
| uncomfortable. I don't know what's going on. | | | | why they're so important to prevent. I'm Gerry |
| Again, the doctor pooh-poohed it and said not to | | | | Oginski. Thank you for joining me. Have a great |
| worry, all the tests before show that you are | | | | day. |
| fine. | | | | |