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Misdiagnosis of heart attacks

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    A blog considering recent news reports that hundreds of thousands of patients have been potentially misdiagnosed in terms of their risk of heart disease and heart attack, and also initially misdiagnosed following a heart attack.

    By Kerstin Kubiak

I have been reading a number of different reports in the news recently concerning potentially widespread problems with information being given to NHS patients both as to their risk of suffering a heart attack or being given the wrong diagnosis when they have actually suffered a heart attack.

This comes following news reports earlier this year which also indicated that a large proportion of patients were receiving poor care following a heart attack and not being given the recommended advice to prevent further heart attacks, and I have written about previously.

What is a heart attack?

The NHS Choices website defines a heart attack as:

a serious medical emergency in which the supply of blood to the heart is suddenly blocked, usually by a blood clot. Lack of blood to the heart can seriously damage the heart muscle. A heart attack is known medically as a myocardial infarction or MI.”

Typical symptoms include chest pain, shortness of breath and feeling weak/light-headed. It is recognised however that not everyone will experience severe chest pain, which is the symptoms most people arguable associate with a heart attack.

Depending on the severity of the heart attack, the patient can suffer long-lasting effects due to the damage to their heart muscle and in very severe cases will not survive. It is reported that early diagnosis and treatment of a heart attack is a key factor in improving survival rates.

Miscalculation of risk of heart attack

In August 2016 it was reported that, due to a ‘glitch’ in computer systems used widely by GPs, many thousands of patients may have been wrongly assessed of their risk of cardiovascular disease and heart attack, and further that many of these patients still have not been notified of this error. The errors date back to 2009 and could affect 260,000 patients.

The errors in the system meant that some patients may have been identified as being at low risk of heart attack and therefore were not offered preventative measures, and others may have been wrongly identified as at higher risk of heart attack and therefore given unnecessary preventative medications.

In May 2016 relevant GPs were first contacted to be alerted of the issues with the computer system, but by August 2016 it is reported that up to half of the GP practices had not even accessed the list of patients potentially affected. Until the errors in the system are resolved then GPs are being advised not to use the software.

Misdiagnosis of heart attack

Also in August 2016 the University of Leeds published results of their study indicating that almost one third of patients in England and Wales are given the wrong initial diagnosis after suffering a heart attack.

The study considered 600,000 cases where a heart attack was eventually the confirmed diagnosis, in 243 NHS hospitals over a period of nine years between 2004 and 2013. Of the 600,000 patients reviewed 198,534 patients were initially misdiagnosed.  The study also indicated that women are more likely to be misdiagnosed than men.

Dr Mike Knapton, Associate Medical Director at the British Heart Foundation, has stated:

This new study highlights the current scale of the issue and confirms more research is urgently needed into tests that will enable earlier and more accurate diagnosis of heart attack.”

It is noted that many patients are also not aware of the potential symptoms of heart attack, particularly where the symptoms do not include the most recognised symptom of severe chest pain, and therefore more work is needed to educate patients to seek medical advice at an earlier time to try and aid earlier diagnosis.

Our experience

As clinical negligence lawyers, my colleagues and I have acted for a number of patients who have suffered heart attacks, often in cases where warning signs were missed and therefore there was a lost opportunity to prevent the heart attack. If the heart attack and subsequent affects could have been avoided or lessened then our clients can seek compensation for their injuries.

From both recent reports it seems that this is an area where potentially hundreds of thousands of patients have been affected. It seems to be recognised that better safeguarding and further development are needed in respect of the assessment of risk of heart attack and also the diagnosis and treatment of heart attacks, to ensure that this is not repeated and I hope that this is given urgent attention.

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