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Ok so when it’s a “silent killer” how can we blame the MD for missing it? Because it’s not the heart attack itself that is actually the silent killer. It’s the risk factors for heart attack that are silent: Coronary artery disease, high blood pressure, and high cholesterol are all commonly asymptomatic. The prolonged presence of these risk factors predisposes people to heart attacks and if they go undiagnosed and untreated several things happen:

1)      Nobody is aware that the person is at risk for a heart attack and therefore they fail to react when the subtle symptoms of nausea or arm pain begin. This includes the patient, their family members, and the physicians involved in their care.

2)      The longer the risk factors are present, the more likely a person is to have advanced coronary artery disease. This places the patient at risk for sudden cardiac death or complications due to a more extensive surgery to treat multiple vessel involvement.

A common myth about heart attacks is that men are at higher risk and that it is something that occurs at 65+ years of age. In fact, women are more likely to die of coronary artery disease and heart attack than men. This is partly due to an extra set of risk factors, such as lupus and hormonal changes; and partly due to atypical presentation of symptoms. (Barclay, 2013). As many as 5% of all 25-64 year olds in the US state they have had a heart attack (CDC).

The study by Wallace et al. (2013) predominately looked at primary care physicians. It is true that your GP is not expecting you to walk in with a heart attack, and this is probably why many of the medical malpractice suits are filed. But preparedness is key regardless of the scenario, and the doctor’s offices should be aware of which of their patients are at risk in the first place. They can’t do this if they don’t look for the risk factors or exclude a patient because of gender or age.


This month’s civil topic is heart attacks as a missed diagnosis in medical malpractice cases. Topics covered are:

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