When your “significant EKG changes” are missed

by Carolyn Thomas  @HeartSisters

A new 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 the diagnostic 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.

It turns out, however, that even when we do finally get hooked up to a 12-lead EKG in a hospital’s Emergency Department, the doctors there may not be able to correctly interpret the “significant EKG changes” that identify heart disease. Continue reading “When your “significant EKG changes” are missed”

Misdiagnosis: the perils of “unwarranted certainty”

by Carolyn Thomas    @HeartSisters

Until being misdiagnosed with indigestion in mid-heart attack, I generally trusted that all people with the letters M.D. after their names knew what they were talking about when diagnosing serious medical problems. That was long before I tracked down a study(1) reported in the New England Journal of Medicine that women under the age of 55 who are experiencing a heart attack are seven times more likely to be misdiagnosed and sent home from the E.R. compared to their male counterparts presenting with identical symptoms.

And that’s why I now find Dr. Jerome Groopman’s landmark book, How Doctors Think, so illuminating.  It should be required reading for all med school students.  Continue reading “Misdiagnosis: the perils of “unwarranted certainty””

“Gigi”: An E.R. doc’s warning to his residents

by Carolyn Thomas

An experienced E.R. physician is supervising a regular training lesson for residents in his hospital’s Emergency Medicine program one morning. The class is reviewing EKGs, going over interesting cardiac cases from their E.R., and reviewing subtle abnormalities in lab work or x-rays.

His residents are willing to put in this extra time to become better E.R doctors.

On the EKGs shown overhead on the big screen, the name of each heart patient being discussed is whited-out to protect patient confidentiality. What isn’t hidden, though, is the name of the EKG tech who performed the EKG procedure on the patient. And there, in the left lower border of EKG #6’s information box, the E.R. doc spots the technician’s name.

“Gigi”.     Continue reading ““Gigi”: An E.R. doc’s warning to his residents”