Misdiagnosis of heart attack

[Narwhal7]

Does anyone have experience of presenting at A&E with chest pain, no abnormalities on the ECG, no troponin test then having a heart attack/ cardiac arrest at home later that day/week?

[bantam12]

My husband collapsed with complete heart block a week after the all clear from A&E.

[Milkfairy Heart Star]

Hello Trini77

Welcome to the forum

It can sometimes be difficult to diagnose a heart attack.

It has also been shown that women often have their heart attacks misdiagnosed, receive less invasive treatment and preventative medication afterwards.

The BHF launched a campaign about this biological bias last year.

bhf.org.uk/informationsuppo...

[Cliff_G]

Trini77, I sincerely hope the latter heart attack/cardiac arrest was indeed "only" that. Is this yourself or someone else? And what happened after the second event?

It might not be this, but there is one condition which can present very much like that, great pain in chest, back, neck or abdomen, can feel like a heart attack, normal ECG and bloods, nothing on x-ray, and pain recedes but then comes back. The condition is Aortic Dissection and needs a CT scan to properly diagnose it - urgently. If the dissection occludes the coronary arteries it can cause an "actual" heart attack, and if the dissection flap is mobile, it's probably possible that it could come and go.

Key features are a very sudden (1 or 2 seconds) pain onset, rather than 10 to 20 minutes, and especially if there is a collapse.

If there is any chance this is what you have, please go to A&E straight away and ask for a CT to exclude aortic dissection. All A&Es should have the Think Aorta poster which is at thinkaorta.org

Do let us know what happens

[Sunnie2day in reply to Cliff_G]

Thank-you so much for the link! I have 'trivial' (for now according to the cardiologist) scarring on my aortic valve and every nugget of information is of great interest to me. Bookmarked for further reading, thank-you again!

[Cliff_G in reply to Sunnie2day]

Hi, Think Aorta is concentrating primarily on the problem of missed diagnoses of AD in the emergency setting (unfortunately still too frequent). However, there is also a patient leaflet there to help those who might have found they have an aortic risk but again, this is more to do with such things as an incidental finding of an aneurysm, or if you have a connective tissue disease such as Marfan.

I don't think scarring on your aortic valve (did your Cardio say you had mild stenosis?) is a risk factor for these serious aortic diseases, and indeed may be entirely limited to the valve and be a cardiac-only issue. Whilst the two are obviously physically linked, problems with the AV vs. the aorta can be entirely separate issues. From what you've said, I would not be worrying about "proper" aortic disease.

[Sunnie2day in reply to Cliff_G]

I did ask about stenosis specifically when he used 'trivial' to describe the scarring (there since a childhood bout of rheumatic fever morphed into Rheumatic Heart Syndrome) and he said no, just 'trivial' and I'm monitored yearly (echo).

I downloaded the leaflet earlier. I know I'm not in line to be terribly worried about AD but I have become quite interested in all aspects of problems associated with aortic dysfunction so your link is brilliant, thank-you again for posting it. Bonus is the way other links are listed on the site there to further reading.

[HHH2017]

I do hope you are ok. As Milk Fairy says diagnosis in women is really difficult I was sooo shocked when told I’d had a HA!

Whatever your situation I hope you are getting the correct treatment now or are keeping a very close eye on your symptoms. Best of luck.

[Maisie2014]

Oh yes. I think that’s why I get such good care now.