Home Tests & Diagnosis Misdiagnosis of Heart Disease

Misdiagnosis of Heart Disease - How to Prevent Misdiagnosis

Choose the right doctor

Very often the difference between feeling like you aren’t being paid attention to and getting the care you need comes down to your choice of doctor. Your doctor should be someone with whom you feel comfortable sharing your health concerns. Finding a doctor you communicate well with before you really need one can cut down on the stress of experiencing worrisome symptoms and looking for a new healthcare provider at the same time.

Recommendations may come from friends (be sure to check credentials too) or you can call a local hospital for a referral. Your insurance provider may also have a tool that lets you search for doctors who accept your insurance.

Know your symptoms

To give your doctor the best chance at getting your diagnosis right from the start, be specific and objective about your symptoms and ready to describe them clearly. Keep describing your symptoms until you feel you’re understood. Take time to organize your thoughts before visiting the doctor: good communication with your healthcare provider is a key step in getting the best possible healthcare.

Tell your doctor:
• What symptoms you’ve been having
• How long you’ve been having them
• How often they occur
• What time they usually occur
• What you have been doing when they occur

Remember

Be specific:
YES: “Early last week I started feeling a tightness in the middle of my chest that comes and goes, and my heart feels like it’s pounding against my chest. It happened once when I was walking to the store and a few times when I was watching TV. What do you think is causing this?”
NO: “I just haven’t been feeling well lately. My chest hurts and I’ve been feeling stressed and nervous. Am I just being paranoid? ”

Be objective:
YES: “I haven’t been able to finish my daily walk without getting out of breath and having to stop and rest.”
NO: “Lately I feel like I just don’t have any energy.”

Also see: Talking to Your Doctor about Heart Disease

Know the facts

Be an informed consumer: read about your condition(s) and symptoms online and in books, magazines, and newspapers. Learn what the standard tests are, what limitations the tests have, and what other tests can be used (See our Testing Overview). Don’t fall into the trap of trying to diagnose yourself. Health knowledge should be used to make sure you get the best care possible and know your options: no amount of research can replace the specialized training and experience of doctors.

Get Results

Make sure both you and your doctor receive and follow up on any test results. Don't assume that “no news is good news.” If you don’t get the results when expected, call your doctor and ask for them. When you get the results, ask what they mean for your care.

I think I’ve been misdiagnosed. What can I do?

Speak Up

The most important thing if you think you’ve been misdiagnosed is don’t stop until your concerns are addressed. No one knows your body better than you do. Even if your doctor doesn’t find anything wrong with you or tells you it’s just your nerves, don’t stop seeking care as long as you have a problem. Ask your doctor about testing options. If you feel your doctor isn’t listening to you, you can get a second opinion or change doctors.

Get More Tests or Ask for Tests to be Repeated

No diagnostic test is foolproof, and each one has its limitations. Although rare, it’s possible that your test was a false negative (it missed a problem that was there) or a false positive (it says there is a problem that doesn’t really exist). Some tests will fail if the patient has certain other conditions, and some tests (such as the exercise ECG) are less reliable in women than in men. When test results are inconclusive or when you are simply not convinced of your diagnosis, ask your doctor whether the test is really conclusive, whether there are alternative tests that may be more reliable, and what next steps he or she is planning to get to the bottom of your symptoms. Do research on your own about the different available tests, what they’re used for, and how well they work in women. To learn more, visit our section on Testing & Diagnosis.

When should I Get a Second Opinion?

If you know or suspect you have heart disease, but your doctor or the ER doctor hasn’t addressed all your concerns, you should get a second opinion from a clinical cardiologist (also called a noninvasive cardiologist). After a visit to the emergency room, always follow up with a visit to your doctor or a cardiologist—the ER doctor is NOT a substitute for your own doctor.

You should seek a second opinion if:
• You are unable to communicate with your doctor, or he or she refuses to address your concerns
• Your symptoms haven’t gotten any better after following the treatments and lifestyle changes your doctor recommends
• You are experiencing increased anxiety or missing work because of your symptoms
• You simply want another point of view regarding a decision on diagnostic testing or treatment options

Tips On Getting a Second Opinion

Don’t worry about offending your doctor by getting a second opinion: your health is the first priority. When you go for a second opinion, make sure you have a copy of all your own medical records and bring an extra copy for your cardiologist. You may have to call the different medical offices and hospitals where you received testing or treatment. If they ask why you need the records, simply tell them that you want your own copy. To avoid delays, it’s best not to ask to have your medical records faxed: if you go get them in person, you’ll save time and frustration.

Make sure to bring:
• Results of electrocardiogram ( ECG) and blood tests
Echocardiogram, Holter monitor, and coronary angiogram reports
• Medical records from any past hospitalization
• List of medications you are taking, including supplements
• List of allergies (to medications or the dye that is injected during an angiogram)

How can I find a cardiologist who specializes in women’s health?

It can be difficult to locate a cardiologist who is sensitive to the needs of women with heart disease, and the search can be frustrating. For most women, there is simply no shortcut to working with your insurance provider to find cardiologists who take your insurance until you find one who will truly listen. Know your symptoms, do your research, and make yourself heard.

For women living near certain cities, our partner site WomenHeart.org has a list of women’s heart centers in 18 states with details on each program. Click here to learn more.

References

  1. Schiff GD, Kim S, Abrams R, Cosby K, Lambert B. Diagnosing diagnosis errors: Lessons from a multi-institutional collaborative project.: Agency for Healthcare Research and Quality; 2005.
  2. Pope JH, Aufderheide TP, Ruthazer R, et al. Missed diagnoses of acute cardiac ischemia in the emergency department. N Engl J Med. 2000;342:1163-1170.
  3. Mosca L, Jones WK, King KB, Ouyang P, Redberg RF, Hill MN. Awareness, perception, and knowledge of heart disease risk and prevention among women in the United States. American Heart Association Women's Heart Disease and Stroke Campaign Task Force. Arch Fam Med. 2000;9:506-515.
  4. Maynard C, Weaver WD, Lambrew C, Bowlby LJ, Rogers WJ, Rubison RM. Factors influencing the time to administration of thrombolytic therapy with recombinant tissue plasminogen activator (data from the National Registry of Myocardial Infarction). Participants in the National Registry of Myocardial Infarction. Am J Cardiol. 1995;76:548-552.
  5. Goldberg RJ, O'Donnell C, Yarzebski J, Bigelow C, Savageau J, Gore JM. Sex differences in symptom presentation associated with acute myocardial infarction: a population-based perspective. Am Heart J. 1998;136:189-195.
  6. Canto JG, Shlipak MG, Rogers WJ, et al. Prevalence, clinical characteristics, and mortality among patients with myocardial infarction presenting without chest pain. JAMA. 2000;283:3223-3229.
  7. Morise AP, Diamond GA. Comparison of the sensitivity and specificity of exercise electrocardiography in biased and unbiased populations of men and women. Am Heart J. 1995;130:741-747.
  8. Barolsky SM, Gilbert CA, Faruqui A, Nutter DO, Schlant RC. Differences in electrocardiographic response to exercise of women and men: a non-Bayesian factor. Circulation. 1979;60:1021-1027.
  9. Kugelmass AD, Houser F, Simon A. Diagnostic results: Gender continues to make a difference. J Am Coll Cardiol. 2001;37:497A.


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