The misdiagnosed of a patient condution cause the delay of management and do harm to the patient.

As the first rule of being a doctor is ” DO NO HARM”, so misdiagnosis the illness of a patient is a CRIME.

We should strive to avoid misdiagnosis and my advice is if we are in doubt, we should order more test to confirm or to rule the diagnosis.

BUT first, it’s is vital to get a proper history from the patient. Then a thorough clinical examination and to arrive a diagnoses of a set of differential diagnosis and follow with the appropriate investigations to conform or to rule out investigation.

MIS-DIAGNOSIS a condition often arise from inadequate history taking, clinical examination and investigation.

Let take this case

55 year-old INDIAN man complain of epigastric pain a/w left arm pain.

The initial diagnosis by the GP is gastritis and gouty arthritis.

Careful history taking reveal that he is a smoker and do not have any previous history of gouty arthritis nor history of indigestion.

Symptoms of the pain is sudden, severe associated with sweating and nausea.

THIS GP obviously failed to get a proper history, given his age, his race  and risk factor, the GP could have entertained other important diagnosis such as Heart attack.

The patient had sought treatment at A&E department 1 day later after the pain remain unresolved.

At A&E, a ECG reveal ST elevation at V1 to V4 with the deep Q being formed.

THE MAN IS HAVING a HEART ATTACK – acute anterior-septal STEMI.

AND because the misdiagnosis by the GP, the patient can’t received a dose of thrombolytic therapy and thus he missed the opportunity of effective treatment