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Clinical and pathological discrepancies and cardiovascular findings in 409 consecutive autopsies

Aline Fusco Fares1, Jorge Fares, Gislaine Fusco Fares

  • 1Hospital de Base, Faculdade de Medicina de São José do Rio Preto, Av. Brigadeiro Faria Lima 5544, São José do Rio Preto, SP, Brazil.

Arquivos Brasileiros De Cardiologia
|October 28, 2011
PubMed

Insights

Clinical cardiovascular diagnosis accuracy remains a challenge, with significant discrepancies found between clinical assessments and autopsy findings in Brazil. Autopsies are crucial for improving patient care and understanding disease progression.

Area of Science:

  • Cardiovascular pathology
  • Clinical diagnostics
  • Autopsy studies

Background:

  • Persistent global discrepancies between clinical diagnoses and autopsy findings highlight diagnostic challenges.
  • Cardiovascular diseases are a significant cause of mortality, necessitating accurate clinical diagnosis.

Purpose of the Study:

  • To evaluate the accuracy of clinical cardiovascular diagnoses against postmortem findings.
  • To assess the extent of clinic-pathological discrepancies in cardiovascular disease at a Brazilian tertiary-care hospital.

Main Methods:

  • Analysis of 409 consecutive autopsies performed between 2003 and 2006.
  • Application of Goldman's classification system to compare clinical and autopsy cardiovascular findings.
  • Data collected from a tertiary-care hospital in São José do Rio Preto, SP, Brazil.

Main Results:

  • Cardiovascular causes accounted for 42.8% of autopsy diagnoses.
  • Major discrepancies (Class I and II) were observed in 56% of cardiovascular death cases.
  • High rates of misdiagnosis were noted for mesenteric infarction (84.6%), acute myocardial infarction (64.7%), aorta dissection (64.2%), and pulmonary embolism (62.5%).
  • Congestive heart failure (59%) and acute ischemic stroke (58.8%) showed higher concordance rates.

Conclusions:

  • Significant clinic-autopsy discrepancies in cardiovascular death diagnoses persist in Brazil.
  • Postmortem examinations remain vital for enhancing medical care and diagnostic accuracy.
  • Technological advancements have not fully resolved these diagnostic disparities.
Abstract

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