Article Text

Download PDFPDF
Learning from errors
The pitfalls of premature closure: clinical decision-making in a case of aortic dissection
  1. Bharat Kumar1,
  2. Balavenkatesh Kanna2,
  3. Suresh Kumar2
  1. 1Saba University School of Medicine, Devens, Massachusetts, USA
  2. 2Department of Internal Medicine, Lincoln Medical and Mental Health Center, Bronx, New York, USA
  1. Correspondence to Bharat Kumar, bharatk{at}


Premature closure is a type of cognitive error in which the physician fails to consider reasonable alternatives after an initial diagnosis is made. It is a common cause of delayed diagnosis and misdiagnosis borne out of a faulty clinical decision-making process. The authors present a case of aortic dissection in which premature closure was avoided by the aggressive pursuit of the appropriate differential diagnosis, and discuss the importance of disciplined clinical decision-making in the setting of chest pain.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests None.

  • Patient consent Obtained.