Cardiac or heart disease is the general term for medical conditions that affect the heart and its blood vessels.
Heart disease can be experienced in four main ways:
- Angina: this is when you experience chest pain, usually when you are being active, but it can also occur at rest. The pain is caused by narrowing of the arteries which supply the heart muscle, resulting in reduced blood flow. Just as you can get a cramp in your leg when you exercise, angina is like a cramp of the heart muscle. Angina is not an immediate threat to life but indicates the presence of heart disease which will require treatment.
- Heart attack: this is when the blood flow to part of the heart muscle suddenly stops. It is typically experienced as a chest pain which radiates down the left arm or up the jaw, neck and throat. Typically, a person suffering a heart attack feels a ‘sense of impending doom’. A heart attack is potentially life-threatening, and prompt treatment must be sought.
- Cardiac arrest: this is when the heart stops beating. Cardiac arrest is a life-threatening emergency and requires immediate specialist intervention. Cardio-Pulmonary Resuscitation (CPR) carried out properly could help keep oxygen flowing to vital organs until professional assistance is available.
- Heart failure: this is when the heart does not function properly, meaning that blood is not properly pushed around the body. Heart failure is usually a more chronic condition but in certain circumstances can occur out of the blue. Heart failure is not usually an immediate threat to life.
Other types of heart condition include arrhythmia (abnormal beating), structural defects such as problems with heart valves, infection and weakened heart muscle (cardiomyopathy).
Some statistics: misdiagnosis of heart disease
The World Health Organization estimates that across the world, just under 18 million people die each year from cardiac disease. Closer to home, heart disease accounts for more than a quarter of all UK deaths. Even so, according to the British Heart Foundation, almost one third of people in England and Wales are misdiagnosed when they are having a heart attack. One study carried out by The University of Leeds examined around 600,000 heart attack patients and found that just over 198,500 were misdiagnosed.
The main problem with these statistics is that in the case of a heart attack, time to treatment is critical: the sooner treatment is given, the better the chances of a successful outcome. The study scientists estimated that if the diagnosis were made correctly and in good time, over 250 deaths per year may be prevented. What is more, if correctly diagnosed and treated in a timely fashion with correct medication and procedures, there is a 70% chance of survival.
Women more likely to be misdiagnosed when having a heart attack
Given that research into heart disease has traditionally focused on men, the stereotype of the typical cardiac patient is also male. Consequently, women’s symptoms of heart disease are likely to be downplayed, particularly in the case of a heart attack. This gender inequality is all too prevalent, even though according to the British Heart Foundation, there are no differences in the key symptoms of heart attack between men and women. The resulting difference in care for women is estimated to have been a contributing factor in at least 8,000 deaths in England and Wales over the past 10 years. A recent study by Oxford University concurs: women are 9% less likely to receive a correct cardiac disease diagnosis and 13% less likely to receive the correct medication.
Shortage of equipment and specialists
You may find it hard to believe, but shortage of vital equipment and radiologists who interpret the specialised scans is another reason why people are being misdiagnosed. According to cardiac imaging experts in Scotland, thousands of Scottish patients with cardiac symptoms including chest pain, are not receiving a test called a computer tomography coronary angiography (CTCA) which can detect or exclude heart disease. It is estimated that only 27% of patients with angina-like pain receive the scan which is recommended by the National Institute for Health and Care Excellence (NICE) for all people presenting with those symptoms.
Incorrect diagnosis of a heart attack
On the other hand, diagnosing a heart attack when the heart is completely fine is another potential problem. A heart attack requires treatment with drugs which in themselves can be risky if prescribed without due cause. Just this year, researchers found that the troponin blood test, which is commonly used to diagnose a heart attack, could be unreliable. The study of 20,000 patients attending the University Hospital Southampton showed that 1 in 20 had troponin levels far higher than the manufacturer’s recommended limit, despite having no symptoms or clinical signs of a heart attack.
These results underscore the need for doctors to carefully consider the blood results to avoid diagnosing a heart attack and authorising inappropriate treatment. That inappropriate treatment, recommended by NICE, could include invasive surgery to widen the heart arteries. As the medical director of the British Heart Foundation said, ‘A positive test should not always be interpreted as being due to a heart attack. Other information should be taken into account – for example a patient’s symptoms and the results of other tests including an ECG’.
Cardiac damage following other events
Another thing to consider is that heart damage, including heart attacks and cardiac arrest can occur as a consequence of something else happening. The risk here is that the primary problem takes precedent and subsequent heart damage is not recognised right away, resulting in a delay to treatment.
For example, an interesting paper in the journal Thorax outlines 6 cases in which heart damage secondary to road accident trauma was not recognised until much later. One such case is of a 9-year-old boy who was run over by a trailer. 17 years later he presented with severe heart damage, believed to be related to the old injury.
In another case, an 18-year-old motorcyclist had a road traffic accident and suffered multiple injuries. However, it was only 2 days later, after he became short of breath that an ECG showed a large area of damaged heart muscle.
Then there is the recent story that hit the headlines of a runner who broke her leg during the Cardiff Half Marathon. Her fracture was missed several times before she was admitted to hospital. Sadly, she had a cardiac arrest and died 12 days after sustaining her injury. The coroner ruled that had her fracture been properly managed, she would not have suffered a cardiac arrest and would still be alive today.
At Osbornes Law we have acted for three families over the last couple of years who have lost loved ones due to a failure to diagnose heart attack, leading to the individual family members suffering fatal cardiac arrests several hours later. In two cases the deceased were diagnosed incorrectly – one with asthma and the other with a muscular injury caused by his manual employment.
If you have concerns relating to cardiac treatment provided to you or your family
When you require medical attention, you expect that your problem will be properly diagnosed and treated according to National Guidelines. You certainly do not expect to have heart disease or a heart attack missed and not treated, or to be treated for a heart condition that you do not have. In cases such as these, you may be able to make a claim for medical negligence. If you think that you or a loved one has suffered due to medical negligence, get in touch with our specialist team. We are here to help. Call Stephanie Prior or Nicholas Leahy on 020 7485 8811
Our Promise to You
- We will review your potential claim by advising you on the NHS complaints procedure or other alternative procedure if your case does not relate to NHS care and treatment.
- We will not charge a fee for our time in reviewing your case.
- We can assist you with any issues that you may have regarding the complaints procedure or that you encounter in obtaining copies of your medical records.
- We will advise you of the course of action in respect to your case.