1-1banner
 
medpundit
 

 
Commentary on medical news by a practicing physician.
 

 
Google
  • Epocrates MedSearch Drug Lookup




  • MASTER BLOGS





    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov




    ''Once you tell people there's a cure for something, the more likely they are to pressure doctors to prescribe it.''
    -Robert Ehrlich, drug advertising executive.




    "Opinions are like sphincters, everyone has one." - Chris Rangel



    email: medpundit-at-ameritech.net

    or if that doesn't work try:

    medpundit-at-en.com



    Medpundit RSS


    Quirky Museums and Fun Stuff


    Who is medpundit?


    Tech Central Station Columns



    Book Reviews:
    Read the Review

    Read the Review

    Read the Review

    More Reviews

    Second Hand Book Reviews

    Review


    Medical Blogs

    rangelMD

    DB's Medical Rants

    Family Medicine Notes

    Grunt Doc

    richard[WINTERS]

    code:theWebSocket

    Psychscape

    Code Blog: Tales of a Nurse

    Feet First

    Tales of Hoffman

    The Eyes Have It

    medmusings

    SOAP Notes

    Obels

    Cut-to -Cure

    Black Triangle

    CodeBlueBlog

    Medlogs

    Kevin, M.D

    The Lingual Nerve

    Galen's Log

    EchoJournal

    Shrinkette

    Doctor Mental

    Blogborygmi

    JournalClub

    Finestkind Clinic and Fish Market

    The Examining Room of Dr. Charles

    Chronicles of a Medical Mad House

    .PARALLEL UNIVERSES.

    SoundPractice

    Medgadget
    Health Facts and Fears

    Health Policy Blogs

    The Health Care Blog

    HealthLawProf Blog

    Facts & Fears

    Personal Favorites

    The Glittering Eye

    Day by Day

    BioEdge

    The Business Word Inc.

    Point of Law

    In the Pipeline

    Cronaca

    Tim Blair

    Jane Galt

    The Truth Laid Bear

    Jim Miller

    No Watermelons Allowed

    Winds of Change

    Science Blog

    A Chequer-Board of Night and Days

    Arts & Letters Daily

    Tech Central Station

    Blogcritics

    Overlawyered.com

    Quackwatch

    Junkscience

    The Skeptic's Dictionary



    Recommended Reading

    The Doctor Stories by William Carlos Williams


    Pox Americana: The Great Smallpox Epidemic of 1775-82 by Elizabeth Fenn


    Intoxicated by My Illness by Anatole Broyard


    Raising the Dead by Richard Selzer


    Autobiography of a Face by Lucy Grealy


    The Man Who Mistook His Wife for a Hat by Oliver Sacks


    The Sea and Poison by Shusaku Endo


    A Midwife's Tale by Laurel Thatcher Ulrich




    MEDICAL LINKS

    familydoctor.org

    American Academy of Pediatrics

    General Health Info

    Travel Advice from the CDC

    NIH Medical Library Info

     



    button

    Tuesday, August 10, 2004

    Silent Killers: Sometimes, diseases can be dodgey. And not surprisingly, when the present in an atypical fashion, they sometimes get overlooked. So this story that some heart attacks occur without chest pain holds few surprises:

    In the study, published in the journal Chest, researchers looked at data collected in 14 countries on 20,881 patients hospitalized for acute coronary syndromes. Of those, 1,763, or 8 percent, did not report chest pain. Older patients, women and diabetics were more likely to fall into this group.

    The researchers found that the conditions of about a quarter of such patients were initially misdiagnosed, compared with only 2 percent of patients with chest pain.
    .

    Nothing new or surprising there. In the elderly and diabetics, doctors have to remain ever on guard for the unusual in those groups. However, the next statement gives one pause:

    But in the study, the patients without chest pain were less likely to be given drugs to thin their blood to reduce the risk of further damage, or to undergo surgical intervention. The difference in treatment continued up until the patients left the hospital, when they were less likely to be discharged with prescriptions for drugs to reduce blood pressure or cholesterol.

    The study also found a significant difference in death rates during hospitalization: 13 percent for patients without chest pain versus 4 percent for those with chest pain.

    The authors said that at least some of the difference in survival rates could be explained by differences in health before the heart attacks, and that some might be caused by the delay in diagnosis. But the study also noted that omissions in therapy were not adequately corrected during hospital admission and presumably contributed to the poorer outcome.


    One reason for the differences in mortality could be that the atypical presentations occurred in groups that are less resilient to disease to begin with - the elderly and diabetics. And the differences in medication choices? Could be due to the higher likelihood of intolerance and contraindications to those medications in the elderly and diabetics.
     

    posted by Sydney on 8/10/2004 08:33:00 PM 0 comments

    0 Comments:

    Post a Comment

    This page is powered by Blogger, the easy way to update your web site.

    Main Page

    Ads

    Home   |   Archives

    Copyright 2006