Missed opportunities in the primary care management of early acute ischemic heart disease.

Nearly 1 in 10 patients hospitalized for an acute myocardial infarction (AMI) in this cohort study had seen an outpatient physician within 30 days before the event but were not immediately referred for appropriate diagnostic testing, despite having symptoms concerning for AMI. Failure to use appropriate risk stratification methods such as the Framingham score may have accounted for these missed diagnoses.