30th August 2016 – A significant number of heart attacks are being misdiagnosed in the early stages with serious consequences, and women are at greater risk than men, according to a study.
Researchers at the University of Leeds found that overall, almost a third of patients had an initial diagnosis which differed from their final diagnosis.
Types of heart attack
The two principle types of heart attack are STEMI and NSTEMI.
A STEMI heart attack occurs when a main artery pumping oxygenated blood around the heart becomes totally blocked. If inadequately treated, there is a serious risk of severe and permanent damage to the heart muscle.
NSTEMI heart attacks are more common and involved a partial blockage of one or more arteries. The heart muscle is still at risk of significant damage, but usually this is less severe. The diagnosis of NSTEMI heart attacks is made more difficult by the fact that some patients will have a normal electrocardiogram (ECG) and over half will have non-diagnostic ECG changes. Patients may also have symptoms that are not typical of a heart attack, especially in the elderly, women and in patients with diabetes, chronic kidney failure or dementia.
The research team found that women who were eventually diagnosed with the more serious type of heart attack, STEMI, had a 59% higher chance of being originally misdiagnosed than men.
Meanwhile, women who were finally diagnosed with NSTEMI had a 41% greater chance of being wrongly diagnosed than men.
The misdiagnosis rates were much lower in patients with STEMI (3.3%) than with NSTEMI (17.9%), but if those patients who were admitted with other initial diagnoses received a correct diagnosis on first assessment, then 33 deaths in STEMI patients and 218 deaths in NSTEMI patients per year might have been prevented.
Surviving a heart attack
The study found that these misdiagnoses were having an impact on survival rates. Women who received the wrong diagnosis had around a 70% higher risk of dying after 30 days than those who were correctly diagnosed initially.
This higher risk also applied to men, the researchers say.
The study, published in the European Heart Journal Acute Cardiovascular Care, looked at 564,412 patient cases in England and Wales.
Dr Chris Gale, associate professor of cardiovascular health sciences and honorary consultant cardiologist at the University of Leeds, who worked on the study, comments in a statement: "We need to work harder to shift the perception that heart attacks only affect a certain type of person. Typically, when we think of a person with a heart attack, we envisage a middle aged man who is overweight, has diabetes and smokes. This is not always the case; heart attacks affect the wider spectrum of the population – including women."
Be aware of the symptoms
Dr Mike Knapton, associate medical director at the British Heart Foundation (BHF) which part-funded the study says in a statement: "The difference between men and women is alarmingly high, but recent BHF research in Edinburgh has shown one reason why this might be.
"The research shows that when different limits are applied to the troponin test, a routine test for a heart attack, more women receive a correct diagnosis of heart attack. Thanks to this research there is now a better test for female heart attack diagnoses.
"However more research is urgently needed into tests that will enable earlier and more accurate diagnosis of a heart attack, particularly in women."
The BHF is urging the public and healthcare professionals to be more aware of the signs and symptoms of a heart attack.
Source:webmd
0 komentari:
Objavi komentar