Doctors typically diagnose a heart attack using a rapid, parallel protocol that combines patient history, and Electrocardiogram (ECG/EKG), and cardiac biomarker blood tests. This rigorous protocol begins with evaluating the patient’s vital signs and symptoms followed by a review of medical history. Core diagnostic tests, like the ECG, is usually performed within minutes of arrival to identify abnormal rhythms and distinguish between heart attack types.
The main symptoms of a heart attack include pressure, squeezing, fullness, or pain in the center of the chest that lasts more than a few minutes or goes away and comes back. Other signs are pain or discomfort in one or both arms, the back, neck, jaw, or stomach, and trouble breathing.
When a patient shows these warning signs, physicians must act fast to confirm or rule out a heart attack and restore blood flow. An untreated heart attack can cause permanent heart muscle damage, serious complications, or sudden death. That is why quick diagnosis and treatment matter so much.
In this case, the patient’s emergency physician and the hospital staff did not properly test for, diagnose, or treat his heart attack. The heart attack that killed him was the exact event his symptoms, his history, and his ECG were warning of, and proper care could have prevented his death.
The Townsley Law Firm represented his family and recovered a settlement of over $400,000.
One Normal Enzyme Test Does Not Rule Out a Heart Attack
The patient arrived at a hospital emergency department shortly before midnight complaining of chest pain. His chest pain had started seven days earlier, and he had numbness in his left arm the day before and the day of his visit. These are classic cardiac warning signs, and his history made them even more alarming. He had already suffered two heart attacks and had multiple stents placed, and he was a known patient at that hospital. His blood pressure was also elevated when he arrived.
The emergency physician ordered only one set of cardiac labs. After looking at that single set of results, the physician decided the problem was his back. He prescribed a muscle relaxant for chronic back pain and chest pain, did not consult cardiology, and discharged him home. Later that day, less than 18 hours after he left the emergency department, he was found unresponsive and pronounced dead.
A single normal cardiac enzyme test cannot safely rule out a heart attack. Cardiac enzymes leak slowly into the bloodstream as heart muscle is injured. High levels may not show up for six or more hours after a heart attack begins. A test drawn too early can be normal even while a heart attack is underway, which is why the standard of care calls for repeat testing over time rather than a single draw. Sending a high-risk cardiac patient home after one normal result is a recognized error.
An Abnormal ECG Pointing to Ischemia Demands a Response
An ECG showing possible ischemia is a direct warning that the heart may not be getting enough blood, and it requires a workup and a cardiology consult, not a discharge. Ischemia means inadequate blood flow to the heart muscle, the very process that leads to a heart attack. When an ECG suggests an abnormality in a patient with chest pain, arm numbness, and a cardiac history, the standard of care calls for taking that finding seriously, keeping the patient for further evaluation, and involving a cardiologist.
The physician did the opposite. Faced with an abnormal ECG in a symptomatic, high-risk patient, he did not consult cardiology and instead attributed the symptoms to back pain. Back pain does not explain an abnormal ECG. Disregarding a finding that pointed directly at the patient’s fatal condition is at the center of what went wrong here.
Ignoring a Patient’s Cardiac History Compounds the Failure
A significant cardiac history makes it more likely that chest pain is coming from the heart. It should have made the physician more cautious, not less. A patient with two prior heart attacks and multiple stents who arrives with chest pain, arm numbness, and elevated blood pressure is, by definition, high-risk. Everything about his presentation called for treating a cardiac cause as the leading possibility until it was ruled out through appropriate testing and specialist evaluation. Instead, his history was set aside in favor of a harmless explanation, and the physician did not work through other possible diagnoses that fit his blood pressure and history.
The failures were not limited to the physician. The hospital staff did not properly assess, monitor, and treat the patient, did not accurately document his care, and did not pass critical information about his symptoms to the physician. They also failed to appreciate how complex his condition was and to advocate for his safety. The combination of a symptomatic high-risk patient, an abnormal ECG, and a single early enzyme test should have led to repeat testing and cardiology involvement. The decision to discharge him instead took away his chance at the treatment that could have saved his life.
