Case Archive
Emergency Medicine, Cardiology
Ref. # 14728

A 41 year old Kansas man went to a primary care physician due to chest pain and shortness of breath. An EKG and chest X-rays were normal. The patient was admitted to a hospital for further tests, which included a CT scan and pulmonary function tests. The patient complained of pain radiating from the chest to the arms, and soreness in the neck and upper back. The patient was diagnosed with noncardiac musculoskeletal chest pain and discharged. Two days later the patient was brought via ambulance to the ER with severe chest pain--10 on a scale of 1-10. Blood pressure was 162/104. An EKG was normal. The patient was diagnosed with noncardiac pain and discharged. The next day the patient arrested at home. Paramedics transported the patient to the hospital, where prolonged resuscitative efforts were unsuccessful. The cause of death was listed as arteriosclerotic heart disease with thrombotic occlusion left anterior descending and pulmonary emphysema. A medQuest ER specialist opined there was a negligent failure to perform a stress test during the patient's work-up after the first admission. The attending doctors should have been more alert to cardiac origin during the patient's second ER visit. A medQuest cardiologist reported that during the second ER visit the patient should have been admitted for cardiac work-up. Coronary artery disease should not be fatal. Both experts independently opined that, with appropriate treatment, the patient more likely than not would have lived.

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