Email this article Prehospital hypo- and hyperdiagnosis of non-Q myocardial infarction
- Authors: Pankin OA1
-
Affiliations:
- Issue: Vol 79, No 1 (2004)
- Pages: 8-12
- Section: Editorial
- URL: https://ter-arkhiv.ru/0040-3660/article/view/29734
- ID: 29734
Cite item
Full Text
Abstract
Aim. To estimate prevalence of hypo- and hyperdiagnosis of поп-Q myocardial infacrtion (MI). Material and methods. The results of prehospital diagnosis of MI in 1500 patients examined in 19921996 are reported. Estimation was conducted in different clinico-electrocardiographic and clinico-demographic groups.
Results. Non-Q MI occurred in 74.1% cases. Non-Q and Q MI ran atypically in 33.0 and 12.9% patients, respectively (p < 0.01). Hypo- and hyperdiagnosis of Q and non-Q MI was made in 3.8 and 2.1, 17.3 and 35.9%, respectively. In typical and atypical MI hypodiagnosis was made in 13.4 and 21.2% cases, respectively, while hyperdiagnosis was observed in 19.9 and 45.8% (p < 0.01). The MI hyper/hypodiagnosis coefficient was highest in patients under 45 years of age (2.6%) and in repeated MI(2.5).
Conclusion. Misdiagnosis of non-Q MI is most essential in epidemiology of missed diagnosis in this disease. High incidence of hypo- and hyperdiagnosis in non-Q MI as well as atypical MI are explained by objective difficulty of prehospital diagnosis in these MI variants and high MI alertness of the doctors in low significance of the disease.
Results. Non-Q MI occurred in 74.1% cases. Non-Q and Q MI ran atypically in 33.0 and 12.9% patients, respectively (p < 0.01). Hypo- and hyperdiagnosis of Q and non-Q MI was made in 3.8 and 2.1, 17.3 and 35.9%, respectively. In typical and atypical MI hypodiagnosis was made in 13.4 and 21.2% cases, respectively, while hyperdiagnosis was observed in 19.9 and 45.8% (p < 0.01). The MI hyper/hypodiagnosis coefficient was highest in patients under 45 years of age (2.6%) and in repeated MI(2.5).
Conclusion. Misdiagnosis of non-Q MI is most essential in epidemiology of missed diagnosis in this disease. High incidence of hypo- and hyperdiagnosis in non-Q MI as well as atypical MI are explained by objective difficulty of prehospital diagnosis in these MI variants and high MI alertness of the doctors in low significance of the disease.
References
- Голиков А. П., Панкин О. А. Острый коронарный синдром и ошибки догоспитальной диагностики инфаркта миокарда. Кардиология 2000; 12: 26-29.
- Wellford A. L., Ashcom T. L., Whitney E. J. et al. Changing presentation of coronary heart disease in an inpatient population within the US military health care system. Mil. Med. 1993; 158(9): 598-603.
- Зяблое Ю. И., Округин С. А., Орлова С. Д. Возникновение, течение и ближайший исход острого инфаркта миокарда у мужчин и женщин. Клин. мед. 2001; 11: 26-28.
- Панкин О. А. Демографические аспекты догоспитальной диагностики инфаркта миокарда. Тер. арх. 2001; 4: 12-16.
- Валеева Р. М., Лещинский Л. А. Особенности клиники, диагностики и терапии инфаркта миокарда у лиц старшей возрастной группы. Клин, геронтол. 2001; 7(5-6): 53-56.
- Семисотова Е. Ф. Инфаркт миокарда у людей пожилого и старческого возраста. Владивосток: Дальнаука; 1994.
- Критерии догоспитальной диагностики инфаркта миокарда: Метод, рекомендации / Голиков А. П., Полумисков В. Ю., Гусак А. В., Панкин О. А. М.; 1998.
- Панченко Е. П. Тромболитические препараты в лечении больных острым инфарктом миокарда. Атмосфера. Кардиология. 2001; 1: 16-19.
- Alpert J., Thygesen К. Myocardial infarction redefined. J. Am. Coll. Cardiol. 2000; 36: 959-969.
- Белялов Ю. И. Краткосрочное прогнозирование течения нестабильной стенокардии. Кардиология 2001; 10: 81-85.
- Шалаев С. В. Проблемы диагностики острого инфаркта миокарда. Сердце 2002; 1(1): 13-15.
- Короткова А. А., Титов В. Я., Староверов И. И. Прогностическая роль кардиального тропонина I у больных с острым коронарным синдромом без подъема сегмента ST. Кардиология 2002; 4: 19-22.
- Поляков С. В., Глезер М. Г., Персиянов-Дубров И. В. и др. Экономическая эффективность введения в клиническую практику современных методов лабораторной диагностики при остром коронарном синдроме. Экономика здравоохр. 2002; 2(61): 18-20.
- Гуглин Э. Р. О гипердиагностике инфарктов миокарда в связи с анализом больничной летальности. Клин. мед. 1997; 11:76-79.
Supplementary files
