[Hypo- and hyper-diagnostics of non-Q wave myocardial infarction during prehospitalization period]

To estimate prevalence of hypo- and hyperdiagnosis of non-Q myocardial infarction (MI).

The results of prehospital diagnosis of MI in 1500 patients examined in 1992-1996 are reported. Estimation was conducted in different clinico-electrocardiographic and clinico-demographic groups.

Non-Q MI occurred in 74.1% cases. Non-Q and Q MI ran atypically in 33.0 and 12.9% patients, respectively (p < 0.01). Hypo- and hyperdiagnosis of Q and non-Q MI was made in 3.8 and 2.1, 17.3 and 35.9%, respectively. In typical and atypical MI hypodiagnosis was made in 13.4 and 21.2% cases, respectively, while hyperdiagnosis was observed in 19.9 and 45.8% (p < 0.01). The MI hyper/hypodiagnosis coefficient was highest in patients under 45 years of age (2.6%) and in repeated MI (2.5).

Misdiagnosis of non-Q MI is most essential in epidemiology of missed diagnosis in this disease. High incidence of hypo- and hyperdiagnosis in non-Q MI as well as atypical MI are explained by objective difficulty of prehospital diagnosis in these MI variants and high MI alertness of the doctors in low significance of the disease.