Question explored with the scientific record
Conversation so far
- 1 can severe symptoms of gout be misdiagnosed as heart issues
- 2 How often are gout cases mistakenly treated as coronary syndromes?
Answered on this page ↓
How often are gout cases mistakenly treated as coronary syndromes?
The evidence retrieved does not contain a single study that directly measures how often gout is misdiagnosed as a coronary syndrome.
The retrieval returned 20 records. Most are about gout treatment, genetics, or herbal remedies. One case report describes a 46-year-old man with gout history whose aortic dissection was initially called a musculoskeletal problem [1]. That is the closest match, but it is a single case of dissection, not coronary syndrome, and the misdiagnosis was musculoskeletal, not cardiac. Another case report from 2001 describes a fatal aortic dissection misdiagnosed as pulmonary embolism [2]. Neither study quantifies the rate of gout-to-coronary misdiagnosis.
The previous answer correctly noted the biological plausibility: gout flares produce systemic inflammation that can elevate CRP and troponin, and axial gout can cause chest pain. But plausibility is not frequency. Without a study that tracks how many patients presenting with chest pain and elevated troponin are later found to have acute gout rather than acute coronary syndrome, we have no number.
The gap matters. Emergency physicians are trained to rule out heart attacks first. If gout can mimic a heart attack, the rate of misdiagnosis is a patient-safety question. But the literature here does not answer it.
My call: the hypothesis is plausible but unmeasured in the evidence provided. Confidence is low in any specific rate, and moderate in the mechanism, because no study here tested the question.
Sources examined 20
-
Aortic dissection disguised as musculoskeletal condition: a case report and review of literature
A case report highlighting that acute aortic dissection can present with musculoskeletal-like shoulder pain in a rehabilitation setting, risking misdiagnosis, and emphasizing rapid cardiovascular evaluation and multidisciplinary rehabilitation with notable functional recovery af…
DOI: 10.1186/s12891-025-09135-4 -
Investigations of fatal causes of chest pain: Case report and literature review
This case report describes a fatal incident where a patient with suspected ascending aortic dissection (AAD) was misdiagnosed with pulmonary embolism (PE), leading to inappropriate anticoagulation and subsequent death, highlighting the critical need for accurate diagnosis in acu…
DOI: 10.1046/j.1440-1673.2001.00967.x -
Oral Prednisolone in the Treatment of Acute Gout
This study compares the effectiveness and safety of oral prednisolone versus oral indomethacin in treating acute gout in emergency department patients, finding that both treatments provide similar analgesic effects with prednisolone having a better safety profile.
DOI: 10.7326/m14-2070 -
Oral prednisolone is more cost-effective than oral indomethacin for treating patients with acute gout-like arthritis
This study demonstrates that oral prednisolone is significantly more cost-effective than oral indomethacin for treating acute gout-like arthritis in patients presenting to an emergency department in Hong Kong.
DOI: 10.1097/mej.0b013e32832a083f -
Unique Considerations for the Management of Gout in the Hmong Population: Examining Tertiary Encounters at a Large Regional Health Care System
A retrospective chart review at a large regional health system comparing gout-related encounters in Hmong versus non-Hmong adults (2014–2017) found that Hmong patients were younger but had worse renal function, used emergency services more, and had longer hospital stays, with im…
DOI: 10.1002/acr.24490 -
Tophaceous gout of the cervical spine causing cord compression: Computed tomographic diagnosis
This case report describes a rare instance of tophaceous gout in the cervical spine causing cord compression, diagnosed through computed tomography in a patient with a history of chronic polyarticular gout.
DOI: 10.1007/bf02749102 -
Emerging therapies for gout
This review discusses emerging therapies for gout, highlighting their mechanisms, efficacy, and safety based on clinical trial data, while addressing the limitations of current treatments and the need for novel options.
DOI: 10.1517/14728214.2012.736488 -
Gout: an Asia‐Pacific update
This paper provides an Asia-Pacific update on gout, covering epidemiology, pathogenesis, diagnosis, imaging, treatment, and emerging therapies, highlighting regional variations, advances in IL-1–targeted therapy, and practical management considerations for clinicians.
DOI: 10.1111/1756-185X.13103 -
Update on emerging urate-lowering therapies
This paper reviews current and emerging urate-lowering therapies for gout, highlighting the limitations of existing treatments and the potential of new agents like febuxostat and pegloticase.
DOI: 10.1097/bor.0b013e328325bd94 -
Clinical manifestations of gout and their management
This article provides a clinical update on the manifestations, diagnosis, and management of gout across diverse patient groups, detailing acute and chronic treatment options, urate-lowering therapies, and considerations in elderly and renal-impaired patients, as well as emerging…
DOI: 10.5694/j.1326-5377.2000.tb124075.x -
Hydroxyapatite pseudopodagra in a young man: Acute calcific periarthritis of the first metatarsophalangeal joint
This case study describes a 23-year-old man diagnosed with acute calcific periarthritis, initially misidentified as gout, highlighting the importance of recognizing this self-limited inflammatory condition characterized by hydroxyapatite crystal deposition.
DOI: 10.1016/S0735-6757(96)90129-1 -
Co-administration of Colchicine and Allopurinol alleviates vascular calcification induced by hyperuricemia via suppressing inflammation and oxidative stress
Co-administration of allopurinol and colchicine synergistically suppresses hyperuricemia-induced vascular calcification in rats and MSU-stimulated vascular smooth muscle cells by reducing inflammation and oxidative stress, outperforming monotherapies.
DOI: 10.5114/aoms/127037 -
Interleukin-37: associations of plasma levels and genetic variants in gout
Elevated plasma IL-37 is observed in asymptomatic hyperuricemia, intercritical gout, and chronic tophaceous gout, with 15 IL-37 gene variants showing phenotype-specific distributions across gout stages, implying a role for IL-37 in gout progression.
DOI: 10.1186/s13075-023-03188-3 -
ABCG2 contributes to the development of gout and hyperuricemia in a genome-wide association study
This study identifies the ABCG2 gene as a significant contributor to the development of gout and hyperuricemia through a genome-wide association study involving 747 gout patients, 747 hyperuricemia patients, and 2071 controls, revealing specific SNP associations and their implic…
DOI: 10.1038/s41598-018-21425-7 -
Why Does Hyperuricemia Not Necessarily Induce Gout?
This Biomolecules (2021) critical review argues that hyperuricemia alone does not inevitably cause gout, highlighting that monosodium urate deposition and gout flares depend on a pathological tissue environment and multiple inflammatory pathways, with serum uric acid playing bot…
DOI: 10.3390/biom11020280 -
Targeting Hyperuricemia and NLRP3 Inflammasome in Gouty Arthritis: A Preclinical Evaluation of Allopurinol and Disulfiram Combination Therapy
A preclinical rat study shows that combining allopurinol with disulfiram, an NLRP3 inflammasome inhibitor, provides superior urate-lowering and anti-inflammatory effects in gouty arthritis compared with either agent alone, by dual targeting hyperuricemia and inflammasome-driven …
DOI: 10.3390/ph18050762 -
Tabebuia roseoalba: In Vivo Hypouricemic and Anti-inflammatory Effects of Its Ethanolic Extract and Constituents
This study evaluates the antihyperuricemic and anti-inflammatory effects of Tabebuia roseoalba leaf ethanolic extract (EEL) and its constituents in mice, identifying active compounds and demonstrating xanthine oxidase inhibition and reduced MSU-induced inflammation.
DOI: 10.1055/s-0042-105878 -
<p>Converging Relationships of Obesity and Hyperuricemia with Special Reference to Metabolic Disorders and Plausible Therapeutic Implications</p>
A comprehensive systemic review detailing the interconnected roles of obesity and hyperuricemia in metabolic disorders, outlining shared pathophysiology (genetics, epigenetics, adipose inflammation, gut microbiota), major complications (insulin resistance, T2DM, CKD, CVD, cancer…
DOI: 10.2147/dmso.s232377 -
Study on the Anti-Gout Activity of Chlorogenic Acid: Improvement on Hyperuricemia and Gouty Inflammation
This study investigates the anti-gout activity of chlorogenic acid, demonstrating its potential to lower serum uric acid levels and reduce inflammation in hyperuricemic mice and MSU crystal-induced rats.
DOI: 10.1142/s0192415x1450092x -
Study on the Anti-Gout Activity of Chlorogenic Acid: Improvement on Hyperuricemia and Gouty Inflammation
The study shows that chlorogenic acid (CA) reduces hyperuricemia by inhibiting hepatic xanthine oxidase and decreases MSU crystal–induced gouty inflammation in rodent models, suggesting CA as a potential anti-gout agent.
DOI: 10.1142/S0192415X1450092X