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Cases & Commentaries
- Web M&M
Steven K. Polevoi, MD; December 2012
Following an emergency department (ED) evaluation for chest pain, a patient was discharged with a presumptive diagnosis of gastroesophageal reflux disease. Two days later, he returned to the ED in severe distress, now with an acute myocardial infarction and a large pericardial effusion.
Journal Article > Study
Sequist TD, Marshall R, Lampert S, Buechler EJ, Lee TH. Arch Intern Med. 2006;166:2237-2243.
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.