NHS Watchdog Highlights Delays in Critical Heart Attack Treatment

The Healthcare Safety Investigation Branch (HSIB) — the independent watchdog that investigates patent safety concerns in the NHS — has highlighted that patients with suspected heart attacks frequently face lengthy delays to getting life-saving treatment for heart attacks.

Every year there are more than 100,000 people admitted to hospital with heart attacks in the UK. Although a serious condition, medical advances mean that the chances of surviving a heart attack are good. Today there are over 1.4 million people in the UK who have survived a heart attack. However, the chances of survival and recovery are closely linked to getting the right treatment quickly, meaning that any delay to treatment is a serious problem.

The HSIB investigated the most serious type of heart attack, the ST-elevated myocardial infarction (STEMI), in which an artery supplying oxygenated blood to the heart is completely blocked and found significant numbers were waiting up to three hours for treatment. This is despite the NHS recommendation that treatment — a primary percutaneous coronary intervention (PPCI), commonly known as an angioplasty — should take place within 1½ hours of diagnosis.

Instead, the HSIB found that 10% of patients diagnosed with STEMI waited an average of 179 minutes, nearly three hours and twice the recommended time limit. The Myocardial Infarction National Audit Project (MINAP) has found that waiting times have been increasing over the past five years. In their most recent reported year, 2018/19, they found that 31%, nearly one-third, of STEMI patients did not receive treatment within the recommended 1½ hours.

Prompt treatment is vital because the longer the heart is without oxygen the more damage it suffers. The British Cardiovascular Intervention Society suggest that for every 15-minute delay beyond the target there were an additional 6.3 deaths per 1,000 STEMI patients. With over 30,000 STEMI patients a year this means that around 10,000 people every year are exposed to increased risk of death. But even among those that survive the delay can mean additional complications because of the damage their heart has sustained.

Research claims that a third of heart attack patients are misdiagnosed

The situation is even more pessimistic when the problems of misdiagnoses of heart attacks are included. Conclusive medical diagnosis is hard, especially when many conditions and episodes share common symptoms and similar presentations. However, the evidence suggests there is a significant number of misdiagnoses.

Heart attacks are divided into two types, STEMI, where the artery is totally blocked and NSTEMI, where there is a partial blockage. Both heart attacks are serious medical events, but an NSTEMI is the less serious of the two since some oxygenated blood is still making it to the heart. Although the heart is damaged, and the damage will worsen, it does so at a slower rate than in a STEMI patient.

The University of Leeds undertook a lengthy study into the diagnosis of heart attacks. The research collected data from 243 different NHS hospitals which treated 600,000 heart attack patients over nine years. The study is particularly useful because the data were controlled to account for differences that might have been caused by other factors like medical history and lifestyle factors like smoking. This means that the findings cannot easily be explained by other factors outside the hospitals’ control.

The study found 198,534 patients — one-third of the sample in the study — were misdiagnosed when they were admitted, receiving a different diagnosis on discharge from hospital than they were given on admission. In a situation like a heart attack, where the right treatment, given promptly, is crucial to achieving the best outcomes for the patient, such misdiagnoses can have severe consequences.

Perhaps the most shocking was that the University of Leeds study found that women were more likely to be misdiagnosed. Their data suggest that a woman is 50% more likely to have a heart attack misdiagnosed. Although heart attacks are often seen as affecting men, about a third of hospital admissions for heart attacks are for women. Because they are more often misdiagnosed, this means women make up about 40% of the total number of misdiagnoses.

The news gets even worse for women because they are more likely to be misdiagnosed with a less severe, NSTEMI, heart attack. The chances of the misdiagnosis being wrong when they were actually a STEMI patient were 59% (and 41% the other way). This means many women with heart attacks wouldn’t even be identified, initially, as needing the urgent treatment recommended for STEMI patients.

While there are valid reasons that a woman might present differently, this level of misdiagnosis is worrying. Given the number of annual cases it suggests that there might be wider issues behind the diagnosis of heart attacks in women that could be addressed by hospitals to not just remove the discrepancy in misdiagnosis rates, but also improve diagnosis overall.

The University of Leeds study concluded that around 250 people died each year because of a heart attack misdiagnosis. However, this was considered a conservative estimate because of how they selected their sample. In general, they found the chances of survival following a misdiagnosis to be 20% lower than for those patients who had been correctly diagnosed.

The study also did not consider the other potential adverse outcomes for those that did not receive the appropriate in a timely manner. Nor those, as identified by the HSIB and MINAP reports, that were not treated in time despite a correct diagnosis. However, it’s reasonable to expect that the consequences of delays and misdiagnosis are not just unnecessary deaths but are also a heavy toll on the health and quality of life of survivors who should have been able to expect better outcomes.

Heart and circulatory diseases are a leading killer in the UK. One-in-four deaths, more than 160,000 each year, are related to heart and circulation conditions. And while many people’s lives are saved every year, there are still many who unfortunately die, or survive with lifelong consequences, because of the system failures or misdiagnosis leading to delays in the crucial hours immediately after their heart attack.

Compensation for delays in treatment and misdiagnosis of a heart attack

The misdiagnosis or the late diagnosis of a cardiac condition such as a heart attack or an infection such as endocarditis, (an infection of the inner lining of the heart chambers and heart valves), could result in further damage to the heart muscle with serious and long-term consequences.

If you have received negligent medical care or your heart disease or heart attack was misdiagnosed or your treatment was delayed, our specialist misdiagnosis solicitors could help you obtain compensation for your pain, the damage to your health and your loss of income if you were unable to work.

For advice on making a heart attack misdiagnosis claim, contact our medical negligence solicitors today. We provide a free no-obligation case evaluation as well as a ‘No Win No Fee‘ agreement. Call us today on 0333 900 8787, email admin@devonshiresclaims.co.uk or complete our online form to contact us.

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