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To Treat or Not to Treat – That is the Question

Steven E. North, Esq.


In the New York Times of November 18, 2014, page D5, it is reported that cardiologist have historically treated coronary artery blockages with various forms of therapy but have considered “non-obstructive” coronary artery disease as essentially insignificant. The latter condition involves plaque buildup on the arteries which is not significantly obstructing the blood flow to the heart.

The study reports that physicians are less likely to treat these non-obstructive lesions with aspirin or statin drugs to reduce heart attack risk as is done with the obstructive lesion.

The article refers to a study published in JAMA by Dr. Thomas M. Maddox who reports a significant number of patients with non-obstructive disease who had serious potential of heart attack.

This study suggests that patients who are found on angiography or otherwise to have non-obstructive coronary artery disease should be cautioned about their increased risk of having a heart attack and appropriate measures taken.

One of the traditional claims in medical malpractice litigation is the failure to timely diagnose and treat. In New York, there have been many successful such claims relating to the failure to properly manage cardiac risk factors leading to heart attacks with severe heart muscle damage or death.

It is important for the treating cardiologist or family practitioner to appreciate the risks associated with all forms of coronary artery disease and to fully inform the patient of his/her options. Failure to do so can very likely lead to a medical malpractice claim relating to the failure to prevent a heart attack that might otherwise have been avoidable.