Delayed Diagnosis of a Heart Attack
Regrettably, too many patients and their families suffer after delays in diagnosis or treatment of myocardial infarctions. Myocardial infarctions are also known simply as “heart attacks”. A heart attack can occur when blood flow through one or more of the coronary arteries which supply blood to the heart’s muscle is blocked, starving the heart from oxygen-rich blood the heart muscle needs to survive.
A potential lawsuit arising from the misdiagnosis or failure to treat a heart attack is often based on a similar scenario: a patient presents either to a doctor’s office, an urgent care clinic, or an emergency department with a history of chest pain. In addition to chest pain or tightness, the patient may report symptoms such as pain radiating into one arm, nausea, sweating, or shortness of breath. If treating health care providers fail to recognize the patient may be having heart attack and order appropriate testing, the small window of time for life-saving treatment may be lost forever.
Was It Malpractice?
In order to evaluate whether a patient was a victim of medical malpractice related to misdiagnosis delayed diagnosis or treatment of a heart attack, we will need to gather several key pieces of information, including:
- The patient’s age
- The symptoms the patient or their loved one reported to the doctor or the hospital;
- The patient’s medical history, including whether the patient had a history of diabetes, high blood pressure (aka hypertension), or high cholesterol;
- The patient’s smoking history, if any; and,
- The patient’s family medical history, including whether their immediate family were diagnosed or treated for coronary artery disease.
The next step of our investigation is to learn what if any tests were performed by the doctor or the emergency room. In the office setting, if a family doctor or primary care physician suspects their patient may be at immediate risk of a heart attack, the best course of treatment is usually referral to the emergency room.
Once a patient presents to an emergency room with chest pain or other related complaints, the nurses and attending physician should carefully obtain the full history of the patient’s symptoms, their personal and family medical history, and the patient’s vital signs. In addition, there are two diagnostic tests every doctor in the emergency room should consider ordering if they suspect a patient may be suffering from an acute coronary event like a heart attack. These tests are an electrocardiogram and Troponin.
Electrocardiogram (EKG or ECG)
A standard EKG involves 12-leads attached to the chest that measure the electrical activity of the heart. The impulses generated through the leads generate waveforms like those seen in the familiar EKG report (see illustration). Physicians are trained to interpret EKG waveforms and identify abnormalities that could mean the heart muscle isn’t receiving enough blood flow. One common type of EKG abnormality often associated with an especially severe type of heart attack is known as an ST Elevation.
Troponin
Doctors can order a lab test which measures the amount of a protein in the blood called Troponin. The level of Troponin found in the patient’s blood can help doctors determine whether heart muscle was recently damaged or still in the process of being damaged due to a heart attack.
The next step of our investigation is to find out the diagnosis and treatment the hospital or doctor provided for the patient. Ideally, a patient with signs or symptoms of a heart attack will be seen by a cardiologist in the emergency department or admitted to the hospital, often to for emergency treatment. The treatment of a patient in the midst of a heart attack is often time-sensitive. If blocked coronary arteries are not opened up and blood flow to the heart restored, a patient may lose their life. When a patient has lost their life due to the delayed diagnosis of a heart attack, and we find that a doctor or a hospital made a mistake, often a lawsuit will be warranted.
In some cases, a patient will survive in spite of receiving inappropriate or late treatment for a heart attack. If a patient survives in spite of the delayed diagnosis or treatment of a heart attack, and is further evaluated by a cardiologist weeks or months down the line, we would need to learn whether the cardiologist ordered an echocardiogram. An echocardiogram is a test that uses ultrasound to measure the heart’s ability to pump blood throughout the body. One important echocardiogram result, the ejection fraction, can help us understand whether the patient suffered permanent heart damage or faces heart failure as the result of medical malpractice.
We don’t expect you to know every detail of the events surrounding an unexpected and horrific event like a heart attack. The information above is only a guide to help you help us put the pieces together. If we suspect you or a loved one were irreparably harmed by a heart attack and deprived of the medical care you deserved, we will obtain medical records on your behalf. Please contact our firm for a free case evaluation.