School of Medicine, Keele University.
Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, UK.
Coron Artery Dis. 2021 Jun 1;32(4):345-349. doi: 10.1097/MCA.0000000000000975.
Ischemic heart disease is the number one killer in the world. While improvements in the management of acute myocardial infarction (AMI) have resulted in lower mortality rates, there are still cases where AMI is missed with rates varying depending on the setting where the evaluation took place, the population sample, the definition of missed AMI and timing of evaluation. There is consistent evidence that missed AMI is associated with increased risk of complications and mortality. Many factors contribute to missed AMI which include patient factors, clinician factors and institutional factors. While several studies have been conducted to evaluate missed AMI, there is considerable heterogeneity in methodology, which has resulted in variable rates of missed AMI and the factors associated with missed AMI. In this review, we provide an overview on missed AMI discussing rates reported in the literature, why it is important, reasons why it occurs, some of the challenges in evaluating missed AMI and what could potentially be done to reduce these undesirable outcomes for patients.
缺血性心脏病是世界头号杀手。虽然急性心肌梗死（AMI）的管理得到改善，导致死亡率降低，但仍有 AMI 漏诊的情况，其发生率取决于评估发生的环境、人群样本、AMI 的定义和评估时间。有一致的证据表明，AMI 漏诊与并发症和死亡率增加有关。许多因素导致 AMI 漏诊，包括患者因素、临床医生因素和医疗机构因素。虽然已经进行了几项研究来评估 AMI 漏诊，但在方法学上存在相当大的异质性，这导致 AMI 漏诊的发生率和与 AMI 漏诊相关的因素各不相同。在这篇综述中，我们讨论了 AMI 漏诊的概述，包括文献报道的发生率、其重要性、发生的原因、评估 AMI 漏诊的一些挑战以及为减少这些不良后果患者可能采取的措施。
