67y · Male·Ischaemic heart disease; coronary artery atherosclerosis (stented)
…ischaemic-sounding chest pain. Despite multiple episodes of chest pain during admission, initial ECGs and troponins were normal. Following a telephone consultation with cardiology, he was discharged with a plan for outpa…
39y · Male·Ischaemic heart disease with complete occlusion of the left anterior descending …
…ion (cycling, chopping wood) and arm heaviness. The doctor diagnosed reflux oesophagitis, ordered ECG and troponin testing (both normal at 3.5 hours post-symptom onset), and prescribed Losec. The coroner found that while…
74y · Female·acute myocardial infarction due to coronary artery thrombosis
… exertional burning chest pain and diaphoresis; he was unaware of or did not act on a pain score of 7/10; troponin testing was not ordered despite symptoms consistent with ACS; consultation with consultants was not docum…
Male·acute myocardial infarction due to coronary artery disease (all four); specific …
…moking, hypertension, family history); failure to follow diagnostic protocols requiring immediate ECG and troponin testing; misinterpretation of ECG changes or failure to seek specialist ECG interpretation despite availa…
72y · Male·acute cerebral infarction complicating acute myocardial infarction
…pain on 22 and 25 February 2016 to his GP, Dr P., who diagnosed costochondritis without performing ECG or troponin testing despite Bromage's high-risk profile (age, hypertension, hypercholesterolaemia). A cardiology expe…
47y · Female·acute subendocardial septal myocardial infarction complicating hypertension and …
…e classic cardiac symptoms and risk factors. He discharged her after symptomatic treatment without serial troponin testing or repeat ECG—the standard of care. She died from acute myocardial infarction with fatal arrhythm…
72y · Male·ischaemic heart disease secondary to coronary artery disease
…ion secondary to severe triple-vessel coronary artery disease. The critical omission was failure to order troponin testing despite chest pain presentation. While the pleuritic description and atypical features led clinic…
77y · Female·combined effects of ischaemic heart disease and calcific aortic valve sclerosis
…arket. At West Coast District Hospital, her ECG was abnormal but a cardiology registrar advised deferring troponin testing and arranging outpatient echocardiogram rather than urgent transfer to Royal Hobart Hospital's ca…
43y · Female·acute toxic effects of amitriptyline
…a mental health assessment pod, despite abnormal ECG findings with T-wave changes not fully investigated (troponin test ordered but not sent). She was unsteady on transfer and displayed involuntary movements attributed t…
86y · Female·Cardiogenic shock
…6 years old, presented to an urgent care centre with two days of chest pain and vomiting. A point-of-care troponin test (i-STAT) returned 0.4 ng/L, interpreted as normal, and she was discharged with gastritis. She deteri…
55y · Female·acute myocardial infarction due to right coronary artery thrombosis
… department with 24 hours of chest pain, arm pain, sweating and vomiting was discharged without an ECG or troponin measurement. She had an abdominal CT suggesting cholecystitis, but the coroner's medical advisor noted th…
41y · Female·acute myocardial infarction
…est pain guidelines, which required two negative features but Ms Lawrence had none; (3) failure to repeat Troponin T testing as recommended in the hospital's own protocols when initial results were borderline. A second T…
32y · Female·ischaemic heart disease complicated by upper gastrointestinal haemorrhage
…d senior doctor diagnosed oesophagitis, ordered morphine, and discharged her after ~2 hours with a single troponin test and ECG. She died the next day from acute coronary thrombosis complicated by upper gastrointestinal …
35y · Female·coronary artery dissection
…, presented to Wallaroo Hospital with chest pain, arm weakness, and diaphoresis. Ambulance noted elevated troponin (121) and activated the chest pain protocol. However, Dr M. discharged her after 1.5 hours, attributing s…
47y · Female·Cardiac arrhythmia due to severe coronary artery atherosclerosis
…ral hospital with chest pain. The doctor diagnosed muscular pain (99% certain) and discharged her without troponin testing or admission, despite chest pain being the presenting complaint. She died of cardiac arrhythmia s…
42y · Male·ischaemic heart disease due to coronary atherosclerosis
…n complete history despite paramedic documentation of morning chest pain. ECG showed nonspecific changes; troponin was normal but single test insufficient given symptom timing. Expert evidence established that proper his…
49y · Male·ischaemic heart disease with coronary artery thrombosis (left main stem coronary…
…as low-risk for myocardial infarction without repeating the ECG or establishing a working diagnosis. When troponin results returned at 45 ng/L (elevated), Dr V. misinterpreted the pathology report and took no action, fai…
49y · Female·Acute myocardial infarction secondary to giant-cell arteritis and atherosclerosi…
…in described as atypical and unlikely ischaemic, given absent traditional cardiac risk factors. No ECG or troponin testing was performed; an exercise stress echocardiogram was ordered for investigation days to weeks late…
69y · Male·Intracerebral haemorrhage due to sepsis (Staphylococcus aureus bacteraemia), com…
…tion and atrial fibrillation presented to a rural hospital with fever, lethargy, tachycardia and elevated troponin. The treating doctor diagnosed NSTEMI based on the elevated troponin and cardiac history, administering a…
57y · Female·Haemopericardium complicating ascending thoracic aortic dissection
…lower limb neurological symptoms was diagnosed with musculoskeletal back pain and discharged after normal troponin serial testing. She died five days later from haemopericardium due to ascending thoracic aortic dissectio…
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