Hospitals should run a continuing check on such emergency room diagnoses and decisions, Henry said. "If they are too high, corrective action should be taken," he said.
Heart attack diagnosis has been the focus of "a number of quality improvement initiatives," said Dr. Frederick A. Masoudi, an associate professor of medicine at the Denver Health Medical Center, who wrote an accompanying editorial.
"It is well known that timing is of the essence in treating these patients," Masoudi said. "The outcome is better when the artery is opened in a timely way."
False positives are inevitable in some cases, he said. "It is really impossible to say from this one study whether there are too many or too few," Masoudi said. "Ultimately, it is important for us to evaluate the extent to which it occurs and why it occurs. We must build into the system a balance, so that only those patients who need reperfusion get it."
Heart attacks, STEMI and otherwise, are described by the Cleveland Clinic.
SOURCES: Timothy D. Henry, M.D., director, research, Minneapolis Heart Institute Foundation; Frederick A. Masoudi, M.D., associate professor, medicine, Denver Health Medical Center; Dec. 19, 2007, Journal of the American Medical Association
All rights reserved