63% of the myocardial infarctions identified by cardiosvacular medical imaging were missed in routine medical care,
Most Heart Attacks Are Missed in Routine Medical Care
Unrecognzed heart attacks refer to sub-clinical events that are missed in routine medical care but are picked up by electrocardiogram (ECG) or by cardiovascular magnetic resonance (CMR) imaging, which is more accurate.
63% (156 out of 247) of the myocardial infarctions identified by CMR were missed in routine medical care,” said Dr Acharya. “Unrecognized MI may be more common than recognized MI.”
At ten years, mortality rates were similar in patients with unrecognized and recognized MI (49% and 51%, respectively) and significantly higher than in those with no MI (30%) (p<0.001).
This compares to rates at five years, where the mortality rate of patients with unrecognized MI (13%) was higher than in those with no MI (8%) but was lower than in those with recognized MI (19%).
Dr Acharya said: “This shows that with time, the mortality rate of patients with unrecognized myocardial infarction do not receive medications commonly prescribed to heart attack patients to reduce the risks of death or another heart attack. These include aspirin, high intensity statins, angiotensin converting enzyme (ACE) inhibitors and beta blockers.
Using CMR in patients with cardiac symptoms would likely detect many more heart attacks than traditional diagnostic tests. There are good therapies to treat survivors of MI so finding them early should improve prognosis.”
European Society of Cardiology
February 2, 2018
Dr. Parker’s Commentary
This is quite surprising and disturbing research; most people who have had heart attacks don’t know they have had one, but they face almost the same risk of mortality as someone with a known heart attack.
Also, with an unrecognized heart attack, one just doesn’t get the same kind of wake-up call.
Note that the recommendation in the article is for the person to receive medications that would help them, but doe not recommend life-style changes, which are relatively more important.
Perhaps we can get the TSA screeners at the airports to include a heart scan, or at least have an optional lane for a more complete scan?
“The salutatory effect of surviving a heart-attack: One felt that nothing mattered beyond kindness, good manners and humor.”