Friday, April 08, 2005

How You Can Help the ER Doctor Save Your Life

Chest pain is one of the commonest reasons patients visit the ER. It's been estimated that between 2% and 5% of those cases are misdiagnosed - sometimes with fatal consequences.

Here's what Kevin Helliker, writing in The Wall Street Journal , suggests you can do to make sure this doesn't happen to you:

1. Don't act tough and understate the seriousness of the discomfort you're feeling.

2. Be forthcoming about your personal history - diabetes, hypertension, bad cholesterol, or heart disease in your family. Don't hide anything. If you smoke, admit it. (Medical history is a key component of good diagnostics.)

3. Make sure you tell both the triage nurse and the doctor everything. If one misses an important detail about your condition, the other might pick it up.

4. Ask for an ECG (electrocardiogram) if you are concerned - but recognize that this test only picks up on about half of all heart attacks. So don't let anyone in the emergency room tell you that if your ECG is good, your heart is good.

5. Make sure your doctor reads the ECG itself and not a computerized analysis of it. The computerized reports are even less accurate than the actual ECGs.

6. If you've had a previous ECG, let your doctor know and ask him to compare the two. This makes a correct diagnosis much more likely.

7. Sometimes, a doctor may give you a gastrointestinal "cocktail" if he thinks your chest pain is related to a digestion problem. But just because the pain abates after taking the cocktail doesn't mean you didn't have a heart attack.

8. Even if symptoms disappear, consider a follow-up with your doctor.

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