Delayed Treatment of an Acute Heart Attack
An acute myocardial infarction requires emergency treatment in order to reduce the patient's risk of death. A prompt diagnosis and swift response are of the essence.
The impact of a heart attack
Heart disease is the most common cause of death in the UK, affecting approximately twice as many men as women. An acute heart attack or myocardial infarction, also known as a STEMI or spontaneous ST-segment elevation myocardial infarction, occurs when a restricted or blocked blood supply causes the heart to malfunction.
Delays in diagnosing and treating such occurrences can significantly affect the outcome. According to the National Institute for Health and Care Excellence, around half of the heart's muscular tissue is lost within one hour of the heart attack occurring and up to two-thirds of the tissue is lost within three hours.
A sudden heart attack can result in the death of the patient. Mortality rates for patients in hospital in the UK have been dropping but this is dependent on speed of diagnosis and delivery of appropriate treatment. Treatment within 90 - 120 minutes of the heat attack occurring is recommended.
Treatment of STEMI
The NICE Guidelines state the following in relation to the treatment of people suffering with an acute myocardial infarction:
"Immediately assess eligibility for coronary reperfusion therapy (either PPCI - primary percutaneous coronary intervention or fibrinolysis) in people with acute STEMI. Deliver coronary reperfusion therapy as quickly as possible."
Reperfusion refers to the restoration of blood flow to the threatened organ in order to prevent or reduce damage occurring to the tissue.
PPCI Procedure
Primary percutaneous coronary intervention (PPCI, also known as a coronary angioplasty) is a surgical procedure carried out to unblock a narrowed artery which is threatening the integrity of the functioning of the heart. It involves the insertion of a small balloon into the appropriate artery, usually via the groin, which expands the blood vessel and allows the insertion of a stent which remains in place to enlarge the blood vessel and allow normal functioning to recommence.
The sooner this procedure can take place, the better the chance that the patient will survive with the smallest amount of damage to the heart.
Urgent diagnosis
If the patient is to receive life-saving treatment within 120 minutes, swift and accurate diagnosis of their condition is crucial.
The symptoms which might indicate that a patient is suffering from an acute heart attack might include the following:
- Chest pain which may veer towards the left side and be accompanied by sweating, nausea and palpitations
- Shortness of breath
- Cold, clammy skin
- Irregular pulse
Additional risk factors such as age, family history, male gender, smoking, obesity and diabetes might increase the likelihood that the patient is suffering from a heart attack and should alert medical professional to this possibility.
Misdiagnosis
It is possible, however, that these signs may be misinterpreted, meaning that the patient does not receive the necessary life-saving treatment.
The patient's symptoms could be confused with pneumonia, asthma, anaemia, pulmonary disease or a collapsed lung.
Equally, the patient's medical history may not be considered resulting in a failure to recognise the true cause of their symptoms.
Emergency responses
If it is suspected that the patient is having a heart attack, an emergency response is necessary in order to transfer the patient to hospital.
Once there, the patient may undergo tests to confirm the diagnosis and assess their condition.
These tests could include the following:
- an ECG (an electrocardiogram which measures the heart's activity)
- measuring the patient's cardiac enzymes for signs of damage to the heart
- an echocardiogram or ultrasound of the heart and associated blood vessels
A delay in accessing specialist assessment and treatment can significantly reduce the patient's chance of survival.
A misinterpretation of test results can also result in delayed treatment.
Successful treatment of an acute heart attack relies on the competence and efficiency of all parties concerned including the GP, the ambulance service and the in-hospital staff.
Medical negligence
A failure to recognise symptoms of a heart attack, a delay in providing treatment or access to treatment or a misinterpretation of test results, leading to a poor patient outcome might be considered to have been negligent.
If you or a loved one have suffered due to a failure to respond promptly and appropriately to an acute heart attack, contact us to discuss your experience.
We are a specialist team of medical negligence solicitors and would be happy to advise you as to whether it would be appropriate to make a claim for compensation.
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