%0 Case Reports
%T Lessons in clinical reasoning - pitfalls, myths, and pearls: a case of crushing, substernal chest pain.
%A Trumbull DA
%A Braschi EL
%A Jain A
%A Southwick FS
%A Parsons AS
%A Radhakrishnan NS
%J Diagnosis (Berl)
%V 10
%N 3
%D 2023 08 1
%M 37441731
暂无%R 10.1515/dx-2022-0017
%X Diagnostic error is not uncommon and diagnostic accuracy can be improved with the use of problem representation, pre-test probability, and Bayesian analysis for improved clinical reasoning.<BR>A 48-year-old female presented as a transfer from another Emergency Department (ED) to our ED with crushing, substernal pain associated with dyspnea, diaphoresis, nausea, and a tingling sensation down both arms with radiation to the back and neck. Troponins were elevated along with an abnormal electrocardiogram. A negative myocardial perfusion scan led to the patient's discharge. The patient presented to the ED 10 days later with an anterior ST-elevation myocardial infarction.<BR>An overemphasis on a single testing modality led to diagnostic error and a severe event. The use of pre-test probabilities guided by history-taking can lead to improved interpretation of test results, ultimately improving diagnostic accuracy and preventing serious medical errors.