Misdiagnosis of Chest pain
Misdiagnosis and Chest pain
Heart attacks can be undiagnosed: Although the most severe symptoms of heart attack are hard to miss,
there are varying degrees of severity.
It is altogether too common for people to die from undiagnosed heart attack, or from delaying too long
to call for emergency help.
The prognosis for treatment is far better for patients treated in the early stages of a heart attack.
The most common misdiagnoses include heartburn, or other less severe causes of chest pain.
See the introduction to heart attack and the symptoms of heart attack.
Heart attacks can be overdiagnosed: Although many people die from heart attacks, there are also
many cases where people fear that they have a heart attack, but actually have something milder.
Some of the conditions which may be causes of chest pain, causing fear of a heart attack, including
an anxiety attack, heartburn, and so on.
See the causes of chest pain and the symptoms of heart attack.
Rare heart condition often undiagnosed: The rare heart condition called long QT syndrome can lead to episodes of palpitations
and rapid heartbeat.
In rare cases, this undiagnosed condition can be fatal.
It should be considered for any unexplained heart rhythm abnormality.
Heart attack can be over-diagnosed: Although heart attack is often undiagnosed,
leading to fatality, it can also be over-diagnosed.
People become concerned that a condition is a heart attack,
whereas there are various less dangerous possibilities.
After all, there are numerous causes of chest pain.
Some of the common conditions where a person may become concerned
about a possible heart attack include a panic attack (which often has
both chest pain and difficulty breathing), and heartburn/reflux type conditions.
Nevertheless, chest pain itself can be a potentially life-threatening symptoms,
and needs immediate professional attention.
Leg cramps at night a classic sign: The symptom of having leg muscle cramps,
particularly at night, is a classic sign of undiagnosed diabetes.
However, there are also various other causes.
See causes of leg cramps or misdiagnosis of diabetes.
Blood pressure cuffs misdiagnose hypertension in children: One known misdiagnosis issue
with hyperension, arises in relation to the simple equipment used to test blood pressure.
The "cuff" around the arm to measure blood pressure can simply be too small to accurately
test a child's blood pressure.
This can lead to an incorrect diagnosis of a child with hypertension.
The problem even has a name unofficially: "small cuff syndrome".
See misdiagnosis of hypertension.
Hypertension misdiagnosis common in children: Hypertension is often
misdiagnosed in adults (see misdiagnosis of hypertension), but its misdiagnosis is even more likely in children.
Some of the symptoms of hypertension that can be overlooked include chest pain, headaches, abdominal pain, etc.
See symptoms of hypertension or misdiagnosis of hypertension.
Vitamin B12 deficiency under-diagnosed: The condition of Vitamin B12 deficiency
is a possible misdiagnosis of various conditions, such as multiple sclerosis (see symptoms of multiple sclerosis).
See symptoms of Vitamin B12 deficiency or misdiagnosis of multiple sclerosis.
Chronic lung diseases hard to diagnose: Some of the chronic lung diseases
are difficult to diagnose.
Even the well-knowns conditions such as asthma or lung cancer often fail to be diagnosed early.
Some of the chronic lung diseases with diagnostic difficulties
include asthma (perhaps surprisingly), COPD, emphysema, chronic bronchitis, cystic fibrosis, mesothelioma,
smoker's cough, AIDS-related respiratory conditions (see AIDS), chronic pneumonia, and other respiratory diseases.
Rare possibilities include diseases like psittacosis (bird-related lung infection).
See other types of chronic lung diseases.
Pulmonary embolism- medical emergency: Pulmonary embolism is a
common and potentially lethal disease; unfortunately, the diagnosis is often missed
because patients with pulmonary embolism present with non-specific signs and
symptoms. If left untreated, approximately one third of patients who survive an
initial pulmonary embolism subsequently die from a future embolic episode. Most
patients succumb to pulmonary embolism within the first few hours of the event.
In patients who survive, recurrent embolism and death can be prevented with
prompt diagnosis and therapy. In hospitalized elderly patients, pulmonary
embolism is commonly missed and often is the cause of death. Most patients
treated with anticoagulants do not develop long-term sequelae upon follow-up
evaluation.
Fatal causes of chest pain: Chest pain
is a common condition yet very threatening to both the patient and the doctor
because the underlying aetiology many a times can be lethal especially if it is
of sudden onset. Chest pain is usually considered as myocardial ischemia unless
proved otherwise. Most important causes that are to be kept in mind and to differentiate
from one another would be myocardial infarction, pulmonary
embolism, aortic dissection and tension pneumothorax. Myocardial infarction
must be differentiated from aortic dissection oesophageal reflux and spasm,
anxiety and pericarditis. History remains most important clinical factor to
diagnose. Unfortunately, myocardial infarction and angina are often missed.
Long QT syndrome or epilepsy: This is a serious cardiac disorder which maybe congenital or acquired
due to intake of certain medications.It is characterized by the
prolongation of QT interval on ECG, in an otherwise young healthy
individual with no prior complaints. Although sometimes the patient may
give a history of fainting spells and chest pain especially while
exercising, swimming or during an emotional event. Since it can be
congenital it is imperative to seek evidence of sudden cardiac death in
family members especially at a young age. Long QT syndrome can
also present with seizures hence it is commonly misdiagnosed and
treated as epilepsy.Treatment involves medication and
sometimes patients may require a pacemaker.Certain lifestyle changes such as avoiding causative
drugs, strenuous exercises, swimming, contact sports, emotional
stress are advocated.
Pneumothorax or myocardial infarction?: Pneumothorax can occur spontaneously in individuals with known lung
disorders such as asthma, COPD, tuberculosis, cystic fibrosis, but
sometimes it can also occur in previously healthy individuals,
especially tall thin men who smoke and are between 20 to 40 years of
age. The patient presents with chest pain and shortness of breath,
tightness in the chest which may mimic myocardial infarction. Truamatic
pneumothorax occurs following injuries such as rib fractures, gunshot
or stab wounds or certain medical procedures. If untreated pneumothorax
may complicate into tension pneumothorax, where air can enter into the
pleural cavity but cannot leave and gets trapped . This is a very
serious condition and progresses rapidly and
proves fatal if not treated quickly. Pneumothorax can heal
on its own or may require inserting a needle or chest tube into the
pleural cavity to relieve the pressure.
More about Misdiagnosis
» Next page: FLANK PAIN (Algorithmic Diagnosis of Symptoms and Signs)
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