Possibly Unrecognized Forms of Heart Disease

THE TITLE of this presentation might imply that many forms of heart disease were possibly escaping recognition. Perhaps a more hackneyed title, such as "Pitfalls in Diagnosis, "Missed Diagnoses," or "IRefleetions on Cardiac Diagnosis," would be more appropriate. At the end of the month or semester, one may reflect on his practice and figuratively calculate his diagnostic batting average; the analysis of his errors, minor or major as they mav be, can be a humbling, yet rewarding task. Obviously, all personally unrecognized, or erroneously labeled, forms of heart disease cannot be evaluated during such reflection. It is necessary to have a final diagnosis, obtained either on a subsequent occasion or by a colleague in either a clinical or a pathologic, anatomic setting. General categories of missed diagnloses are: (1) rarities, (2) simulators, (3) complicators, and (4) the emotionally obscured.