In the emergency room, heart attacks can be both over and under diagnosed. About 10% of heart attacks are over diagnosed and an equivalent number can be missed as the ECG can be normal in the first six hours after a heart attack.
Most heart attacks occur during winter all over the world includingIndia. Missing heart attacks during this period in the early hours of the morning can lead to spurts in number of cases of sudden cardiac death.
Moreover, most senior doctors maybe on vacation during Xmas further worsening the situation for the common man.
Every effort should be taken to reduce the number of false positive or false negative diagnosis of heart attack.
In a study published in JAMA, Henry and coauthors studied the medical records of 1,345 people treated for suspected heart attacks in a regional system between 2003 and 2006, looking at emergency room decisions. All patients had classical heart attack called STEMI, a heart attack characterized by a specific ECG pattern. About 14 % of heart attacks were overdiagnosed.
Men and women have about the same adjusted in-hospital death rate for heart attack — but women are more likely to die if hospitalized for a more severe type of heart attack