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Missed acute myocardial infarction: an underrecognized problem that contributes to poor patient outcomes.

Mallen

Authors



Abstract

Ischemic heart disease is the number one killer in the world. While improvements in the management of acute myocardial infarction (AMI) have resulted in lower mortality rates, there are still cases where AMI is missed with rates varying depending on the setting where the evaluation took place, the population sample, the definition of missed AMI and timing of evaluation. There is consistent evidence that missed AMI is associated with increased risk of complications and mortality. Many factors contribute to missed AMI which include patient factors, clinician factors and institutional factors. While several studies have been conducted to evaluate missed AMI, there is considerable heterogeneity in methodology, which has resulted in variable rates of missed AMI and the factors associated with missed AMI. In this review, we provide an overview on missed AMI discussing rates reported in the literature, why it is important, reasons why it occurs, some of the challenges in evaluating missed AMI and what could potentially be done to reduce these undesirable outcomes for patients.

Acceptance Date Sep 20, 2020
Publication Date Jun 1, 2021
Journal Coronary Artery Disease
Print ISSN 0954-6928
Publisher Lippincott, Williams & Wilkins
Pages 345-349
DOI https://doi.org/10.1097/MCA.0000000000000975
Keywords acute myocardial infarction; misdiagnosis; mortality
Publisher URL https://journals.lww.com/coronary-artery/Citation/2021/06000/Missed_acute_myocardial_infarction__an.12.aspx