UMEM Educational Pearls

Category: Cardiology

Title: reflux and ACS misdiagnosis

Keywords: reflux, esophagitis, misdiagnosis, myocardial infarction (PubMed Search)

Posted: 7/20/2008 by Amal Mattu, MD (Updated: 12/6/2023)
Click here to contact Amal Mattu, MD

 The most common misdiagnosis in cases of missed acute MI is reflux esophagitis. Various studies have demonstrated the following factors that lead to this misdiagnosis:
1. 20% of patients with acute MI describe their pain using the words "indigestion" or "burning."
2. Almost 50% of patients with acute MI report an increase in belching during their ischemic symptoms.
3. 15% of patients get some relief of their ischemic pain with antacids and 7% of patients get complete relief of their ischemic pain with antacids.
4. 8% of patients report that their ischemic pain began while eating.

Before you ever write "Reflux esophagitis" or "GERD" on the chart of a patient you are about to send home, think twice about the possibility of acute cardiac ischemia.