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What's in a name?
Author(s) -
O'Rourke Michael F
Publication year - 1997
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1997.tb123167.x
Subject(s) - citation , unit (ring theory) , library science , psychology , computer science , mathematics education
N ames have a powerful effect on human motivation and behaviour. Ask any advertiser "What's in a name?", and you'll get a very positive response. Advertisers thrive on names on the direct and subtle effects that names have on the people they wish to influence and choosing the right name for a product can mean the difference between success and failure. Ask a physician the same question and you'll get a completely different response names refer to diseases and diagnoses accepted by the profession, and these names aid professional communication. Yet, as physicians, we deal with patients and the public as well as with colleagues; we may not appreciate the misconceptions that arise through our use of names that others may consider inappropriate. For example, take three terms in common use in cardiology "myocardial infarction", "hypertension" and "cardiac failure". 1. "Myocardial infarction" means death of myocardium through lack of blood. Yet this term is applied as a diagnosis to persons with acute ischaemic chest pain, when the pain is due to ischaemic stimulation of viable myocardium, and infarction has not yet occurred. Major public and professional education programs have been mounted for early active treatment of "acute myocardial infarction".' Their aim is to limit even prevent myocardial infarction through early diagnosis of the clinical syndrome and use of thrombolytic therapy. But does it make sense to refer to the acute condition as "myocardial infarction"? We are dealing here with occlusive coronary thrombus, and have the means to dissolve thrombus so that infarction can be prevented. Further, pain is due to ischaemia, since infarcted muscle cannot sense pain. Where else in medicine do we describe a treatment for cellular death in order that we can prevent cellular death? Do we, as a profession, believe in cellular resurrection? Can anyone justify use of the term "myocardial infarction" to describe a patient with acute chest pain and ST-segment elevation characteristic of acute coronary occlusionsHistorically, the clinical syndrome was described as "coronary occlusion" by Herrick in 1912,3 and as "coronary thrombosis" by Levine in 1929.4 Surely we should revert to these logical, sensible terms, as the use of illogical, imprecise terms can interfere with public perceptions, and, consequently, despite well intentioned public education, may discourage