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Lessons in clinical reasoning – pitfalls, myths, and pearls: a case of crushing, substernal chest pain.
- Source :
-
Diagnosis (2194-802X) . Aug2023, Vol. 10 Issue 3, p316-321. 6p. - Publication Year :
- 2023
-
Abstract
- Diagnostic error is not uncommon and diagnostic accuracy can be improved with the use of problem representation, pre-test probability, and Bayesian analysis for improved clinical reasoning. A 48-year-old female presented as a transfer from another Emergency Department (ED) to our ED with crushing, substernal pain associated with dyspnea, diaphoresis, nausea, and a tingling sensation down both arms with radiation to the back and neck. Troponins were elevated along with an abnormal electrocardiogram. A negative myocardial perfusion scan led to the patient's discharge. The patient presented to the ED 10 days later with an anterior ST-elevation myocardial infarction. An overemphasis on a single testing modality led to diagnostic error and a severe event. The use of pre-test probabilities guided by history-taking can lead to improved interpretation of test results, ultimately improving diagnostic accuracy and preventing serious medical errors. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 2194802X
- Volume :
- 10
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Diagnosis (2194-802X)
- Publication Type :
- Academic Journal
- Accession number :
- 169953133
- Full Text :
- https://doi.org/10.1515/dx-2022-0017