Emergency physician Dr. Pat Croskerry tells the story of the day he misdiagnosed a patient who was experiencing unstable angina – chest pain caused by coronary artery disease, and often a warning sign of oncoming heart attack. But this is what he’d said before sending that patient home:
“I’m not at all worried about your chest pain. You probably overexerted yourself and strained a muscle. My suspicion that this is coming from your heart is about zero.”
As a heart attack survivor who was sent home from the E.R. with a misdiagnosis of indigestion despite presenting with textbook symptoms (central chest pain, nausea, sweating and pain radiating down my left arm), I’m pretty interested in the subject of why women are far more likely to be misdiagnosed in mid-heart attack compared to our male counterparts.
Dr. Pat Croskerry is pretty interested in the subject of misdiagnosis, too. He’s an Emergency Medicine physician, a patient safety expert and director of the critical thinking program at Dalhousie University Medical School in Halifax. In fact, he implemented at Dal the first undergraduate course in Canada about medical error in clinical decision-making, specifically around why and how physicians make diagnostic errors. Every year, he gives a deceptively simple critical thinking quiz to his incoming first-year med students.
So here’s your chance to practice thinking like a doctor. Try answering these yourself, but as Dr. Croskerry advises, don’t think too hard. If you were an Emergency Department physician, paramedic or first responder, he warns, you’d have only seconds to size things up and make a decision. Don’t read ahead to peek at the answers! Now, here are your questions: Continue reading “Misdiagnosis: is it what doctors think, or HOW they think?”→
Anew cardiac study out of Montréal tells us yet again what women heart patients have already known for years: women receive poorer care during a heart attack than our male counterparts do. Quelle surprise . . . But one specific finding caught my eye: one of the cardiac procedures that these researchers compared in this study was the use of thediagnostic electrocardiogram test (ECG or EKG) in male and female heart attack patients.(1)
They found that women were less likely than men to receive an electrocardiogram within the recommended 10 minutes of arriving in hospital with suspected cardiac symptoms.