Missed Heart Attack Cases: Key Records That Prove Diagnostic Failure
A missed heart attack (myocardial infarction) isn’t just a clinical error—it’s a life-threatening failure in timely diagnosis and treatment. For attorneys handling these cases, the medical record holds the evidence—but only if you know what to look for.
At Lexcura Summit Medical-Legal Consulting, our legal nurse consultants (LNCs) work closely with attorneys to review hospital, ER, and cardiology records. We help identify critical moments, documentation gaps, and deviations from standard care that contribute to diagnostic failure in heart attack claims.
Here’s what we examine—and why these records matter in building a strong case.
❤️ Why Missed Heart Attack Cases Require Medical-Legal Precision
Heart attacks can present with:
Chest pain or pressure
Shortness of breath
Fatigue
Jaw, back, or arm discomfort
Even vague symptoms like nausea or dizziness
These atypical presentations, especially in women, the elderly, and diabetics, often lead to misdiagnosis—frequently mistaken for anxiety, indigestion, or musculoskeletal pain.
The result?
Delayed ECGs
Missed cardiac enzyme trends
Improper discharge
And tragic outcomes, including death
🗂️ Key Medical Records That Help Prove Diagnostic Failure
1. Triage and Initial Assessment Notes
This is where the clock starts. We look for:
Time of arrival vs. time of first provider contact
Reported symptoms and vital signs
Whether chest pain was documented—or overlooked
Risk factors noted (smoking, history, diabetes, etc.)
Red Flag: A delay in recognizing cardiac risk at triage is often the first misstep.
2. ECG Timing and Interpretation
Was an ECG performed within 10 minutes of arrival? That’s the standard. We assess:
Time stamp of the first ECG
Interpretation and comparison with prior ECGs (if available)
Whether the abnormal results were acted on appropriately
Red Flag: Normal ECGs can be misleading. We look for documentation of serial ECGs and provider follow-up—or lack thereof.
3. Cardiac Enzymes and Lab Results
Serial troponins and CK-MB levels are crucial. Our consultants track:
Timing of lab draws
Rising or falling trends
Response to abnormal results
Lab processing delays or missed orders
Red Flag: Many missed MIs occur when initial labs are negative and providers fail to repeat testing.
4. Nursing and Progress Notes
These often hold the unfiltered story. We review:
Changes in pain, vitals, or responsiveness
Documentation of patient concerns
Missed escalation or delayed response to symptoms
Nurse-provider communication records
Red Flag: A nurse noting increased pain or unstable vitals without immediate follow-up often signals a breakdown in care.
5. Discharge Summary and Follow-Up Instructions
In cases where the patient was discharged before the MI diagnosis:
Were proper differential diagnoses documented?
Did discharge instructions include warning signs and follow-up?
Was the patient instructed to return if symptoms worsened?
Red Flag: Discharging a patient with unresolved chest pain and no documented cardiac workup can be robust evidence of negligence.
🔍 How Lexcura Summit Helps Attorneys Uncover the Truth
Our legal nurse consultants:
Build detailed chronologies of care, vitals, and decision-making
Cross-reference standard of care guidelines (e.g., ACC/AHA for MI)
Identify missed opportunities for intervention
Flag documentation inconsistencies or missing records
Prepare litigation-ready reports and expert prep summaries
We also assist in identifying when to bring in cardiology, emergency medicine, or internal medicine experts—and ensure their testimony aligns with the documented facts.
🛡️ Case Example: Fatal MI Misdiagnosed as Anxiety
In one case, a 54-year-old man presented to the ER with chest tightness and dizziness. He was discharged within 90 minutes with a diagnosis of anxiety. No ECG was performed. He died 36 hours later of a massive MI.
Lexcura Summit's review revealed:
Incomplete triage assessment
Absence of ECG or troponin testing
No documentation of cardiac history
A provider note copied and pasted from a previous encounter
Our findings helped the legal team construct a compelling narrative of missed diagnostic steps, ultimately leading to a successful settlement.
⚖️ Final Thoughts
In missed heart attack cases, time is tissue—and documentation is key. If the standard of care wasn’t met, the record will reflect it—often between the lines.
At Lexcura Summit, we help attorneys turn disorganized records into clear, compelling medical-legal insight. With over 200 expert consultants, a 7-day turnaround, and unmatched clinical depth, we make sure no red flag goes unnoticed.
📞 Ready to review a potential missed MI case?
Connect with our team at lexcura-summit.com and let’s build your strongest case yet.
