Once again, heart disease ranked number one in the Centers for Disease Control and Prevention’s (CDC) annual list of causes of death in the United States. Heart disease accounted for nearly 700,000 out of the total of 3.46 million deaths in 2021.
Some groups have a tougher battle with heart disease than others:
- Men have almost a 62% higher rate of death from heart disease than women do.
- Black individuals have higher rates of heart disease and high blood pressure (hypertension) than the rest of the population.
What is heart disease?
Heart disease is a blanket term that covers a lot of conditions, including:
- Diseases affecting blood vessels, including coronary artery disease and atherosclerosis.
- Arrhythmias, or irregular heartbeats, such as atrial fibrillation, premature atrial or ventricular contractions (PACs and PVCs), atrial or ventricular tachycardia (abnormally high heart beat).
- Congenital or birth-related heart defects.
- Diseases of the heart muscle, or cardiomyopathy
- Diseases of heart valves, including regurgitation, stenosis, and atresia
All of these heart diseases can cause be deadly unless treated properly.
Medical malpractice involving the heart
As Texas medical malpractice lawyers, there are two common types of medical negligence that we frequently see involving the heart. The first is the medical mismanagement of diagnosing and treating a heart attack. The second is the failure to identify and treat the dissection of a cardiac blood vessel, such as an aortic dissection.
Heart attack medical malpractice
Heart attacks are often diagnosed and managed by a wide array of physicians, including family practice, emergency, internal medicine, and cardiology physicians, nurse practitioners, and physician assistants.
The classic signs of a heart attack include:
- Chest pain or tightness
- Radiating pain to the shoulder, arm, back, neck, or even the head, including jaw or teeth
- A cold sweat
- Sudden dizziness or feeling lightheaded
Expert physicians who suspect a heart attack will often order lab work for cardiac enzymes and an electrocardiogram (EKG). When a person has a heart attack, heart muscle is damages, releasing cardiac enzymes and proteins into the bloodstream.
One of the cardiac proteins is troponin, and when lab work shows an elevated level, it’s a sign of a heart damage. When troponin is significantly elevated, it’s a sign of a heart attack. This typically warrants a hospital admission and repetitive troponin blood work to monitor the patient’s condition.
An EKG measures the heart’s electrical activity. Physicians who interpret EKGs ordered to evaluate a potential heart attack are interested in whether one specific segment in the EKG lines is elevated, called the ST segment.
An ST-elevation myocardial infarction (STEMI) is life threatening, and the standard of care requires an emergency or immediate cardiac catheterization (cath) procedure by an interventional cardiologist to save the person’s life.
When the ST segment is not elevated, it’s called a non-ST-elevated myocardial infarction (NSTEMI). Under the standard of care, these patients should be started on therapeutic anticoagulation (clot prevention) medication, such as heparin. As long as they are closely monitored and on telemetry, it is acceptable to perform cardiac catheterization within 24 hours, so long as there is no chest pain.
It’s during that up-to-24-hour period of delay for an STEMI cardiac cath that we often see medical malpractice occurs. That’s what happened to a man in his 40s who had sudden chest pain and went straight to a suburban Houston hospital. Let’s call him Henry.
The emergency room doctor immediately ordered and blood work and an EKG. Henry’s troponin levels were significantly elevated—they were through the roof. The EKG showed that he was having an NSTEMI heart attack. The medical team admitted him to a telemetry unit in the hospital with orders for close monitoring, therapeutic anticoagulation with heparin, serial (repeated) troponin levels, and medications to manage his pain.
The problem in Henry’s hospital care is that the medications never completely relieved his chest pain. A cardiologist (heart specialist) was consulted, who noted that Henry’s chest pain was better. It wasn’t absent, though. The cardiologist planned to take Henry to the cath lab the next day and left the hospital. Meanwhile, Henry’s pain level got worse, but the nurses didn’t notify the cardiologist.
Because of sluggish hospital monitoring by the nursing staff and inaction by the cardiologist, Henry died of an NSTEMI heart attack before he was ever taken to the cardiac cath lab.
Aortic dissection medical malpractice
An aortic dissection is a laceration or perforation in the blood vessel. It can often happen after some sort of trauma, such as a car wreck or fall, but can also develop simultaneously. People with this condition often have a sudden onset of severe pain in the chest, back, or stomach area, with shortness of breath or loss of consciousness.
Another man in his 40s in the Houston area was at a social event when he had sudden severe chest pain and shortness of breath. Let’s call him Keith.
Keith was an active man who was overweight and had high blood pressure (hypertension). He went to the hospital after having a sudden onset of chest pain.
Aortic dissections are often worked up in a hospital emergency room. That’s where Keith immediate went when his symptoms started. The emergency physician quickly felt that Keith might have an aortic dissection and ordered a CT angiogram (CTA) of the chest.
Up to this point, the hospital team managed his case appropriately. Medical experts consider the CTA to be the gold standard for the first test to rule out an aortic dissection. This, in fact, is an area physicians and providers drop the ball by failing to order a CTA.
In Keith’s case, though, the medical malpractice began with the radiologist’s botched interpretation of the CTA. He described a “tortuous aorta,” without much more of an explanation. He didn’t recommend an MRI for further evaluation, and the emergency physician asked no questions. Instead, Keith was discharged home and died the next morning.
If you’ve been seriously injured because of poor cardiac or heart care in Texas, then contact a top-rated, experienced medical malpractice lawyer for a free consultation about your potential case.
