How Heart Attacks Get Missed in the Emergency Department

The classic heart attack presentation, crushing chest pain radiating to the left arm in an older male patient, is well recognized. The problem is that heart attacks frequently don’t present that way. In women, diabetic patients, and elderly patients, symptoms are often atypical: nausea, unexplained fatigue, shortness of breath without chest pain, or discomfort in the jaw, neck, or back. These presentations are sometimes attributed to anxiety, acid reflux, or a musculoskeletal cause rather than triggering a full cardiac workup.

Research has found that women who arrive in emergency settings with heart attack symptoms are more likely than men to be misdiagnosed or to experience diagnostic delays. When a provider attributes symptoms to a non-cardiac cause without ruling out a cardiac one, the opportunity for timely treatment closes.

Common Diagnostic Testing Failures

Two tests are central to evaluating possible cardiac symptoms: an electrocardiogram (EKG), which records the heart’s electrical activity, and cardiac troponin blood testing, which detects proteins released when heart muscle is damaged. Failing to order either test, or failing to properly interpret the results, is among the most frequent errors in heart attack misdiagnosis cases. Both tests are time-sensitive, and repeated troponin draws over several hours are often needed to detect a rising pattern consistent with injury.

What a Missed Diagnosis Costs the Patient

A STEMI (ST-elevation myocardial infarction) involves a complete blockage of a coronary artery. An NSTEMI (non-ST-elevation myocardial infarction) involves a partial blockage. Both require prompt diagnosis because the treatments that limit heart muscle damage, clot-dissolving medication or angioplasty to reopen a blocked artery, are most effective in the first hours after symptom onset. The longer the blockage goes unaddressed, the more tissue dies, and the downstream consequences include permanent heart damage, reduced cardiac function, heart failure, and death.

What a New York Heart Attack Misdiagnosis Claim Must Establish

A New York medical malpractice claim requires proof of four elements: a physician-patient relationship creating a duty of care, a breach of the standard of care, a causal link between that breach and the harm suffered, and measurable damages. In a cardiac misdiagnosis case, the standard of care for evaluating possible cardiac symptoms generally calls for an EKG and cardiac biomarker testing. Evidence that those steps were skipped or misinterpreted is central to establishing the breach.

New York also requires a Certificate of Merit under CPLR 3012-a before a malpractice case is filed. A licensed physician must review the records and confirm there is a reasonable basis for the claim. Medical records from the emergency visit, including which tests were ordered, what diagnosis was recorded, and what cardiac testing was or was not performed, form the factual foundation of every case.

Damages Available in Queens County Cardiac Malpractice Cases

New York law allows medical malpractice plaintiffs to seek both economic and non-economic damages, with the amounts recoverable depending on the specific facts and the severity of harm.

Economic damages can include past and future medical expenses, lost wages, and reduced future earning capacity.

Non-economic damages address pain and suffering and loss of enjoyment of life. New York doesn’t cap non-economic damages in medical malpractice cases, which matters significantly when the cardiac injury is severe.

When a patient dies from a missed heart attack, the family may have two separate claims. A wrongful death claim addresses the losses the family sustains. A survival action addresses the pain and suffering the patient experienced before death. Both must be evaluated against the applicable filing deadlines covered above.