Why the study?
What are the causes and consequences of missed myocardial infarction in the emergency room?
What are the causes and consequences of missed myocardial infarction in the emergency room?
Missed myocardial infarction in the emergency room carries a high mortality rate (83%) and is frequently associated with inadequate testing or misinterpretation, especially in younger patients.
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Missed MI warrants diagnostic vigilance especially in younger patients; Level 5 data leave open optimal prevention strategies.
Sixty-four cases of missed myocardial infarction in the emergency room were identified from the records of a major insurance company. The records were reviewed by three health care professionals using established standards of care for myocardial infarction. The diagnosis of myocardial infarction was missed in many cases due to the lack of diagnostic test ordering, poor interpretation of diagnostic tests, and the young age of the patients. Most patients were presented with symptoms compatible with myocardial ischemia. There was an 83% mortality rate in the 64 cases. The cost of settlement and litigation far exceeded the cost of safe, effective, medical care in the cases studied.
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Arthur L. Pelberg (1989) studied this question.
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