title: The silent worker.
abstract: The patient in this case was diagnosed as having a myocardial infarction, exacerbated over time. It has been reported in medical literature that women in such cases may have atypical symptoms that mimic those of other medical conditions and deceive providers into misdiagnosis. A few women present with the classical chest pain, a symptom most people relate to a feeling of a heart attack. This symptom is more typical in males. EMS providers should have a high suspicion of heart disease in any patient who describes their symptoms as common or relative to acute coronary syndromes. Patients at risk include those with high blood pressure, coronary artery disease, increased cholesterol, obesity and diabetes, among others. Given that this patient was resting comfortably and complaining of abdominal pain, the providers could have interpreted her symptoms as mere gastrointestinal discomfort. In this instance, that could have led to an error in diagnosis and serious complications. The receiving ED could have had a cardiac arrest to manage rather than an early, silent acute coronary event. In this instance, contacting medical command, obtaining a focused history and providing general treatment contributed to a positive outcome for the patient.
authors.affiliation: MCP-Hahnemann University, Philadelphia, USA.
authors.forename: Peter E
authors.initials: PE
authors.lastname: Cunnius
authors.forename: Morris D
authors.initials: MD
authors.lastname: Kerstein
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis; D002637:Chest Pain / Q000175:diagnosis; D003937:Diagnosis, Differential; D004634:Emergency Medical Technicians; D004638:Emergency Treatment / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000628:therapy; D010808:Physical Examination; D014481:United States