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	<title>Comments on: Heart attack misdiagnosis in women</title>
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		<title>By: Carolyn Thomas</title>
		<link>http://myheartsisters.org/2009/05/28/heart-attack-misdiagnosis-women/#comment-47992</link>
		<dc:creator><![CDATA[Carolyn Thomas]]></dc:creator>
		<pubDate>Sun, 13 May 2012 22:23:08 +0000</pubDate>
		<guid isPermaLink="false">http://myheartsisters.org/?p=1228#comment-47992</guid>
		<description><![CDATA[Dear Concerned - your symptoms may or may not be heart-related, but right now you just don&#039;t know for sure. You absolutely did the right thing by seeking help when you did - do not hesitate to call for help again if symptoms persist or get worse.]]></description>
		<content:encoded><![CDATA[<p>Dear Concerned &#8211; your symptoms may or may not be heart-related, but right now you just don&#8217;t know for sure. You absolutely did the right thing by seeking help when you did &#8211; do not hesitate to call for help again if symptoms persist or get worse.</p>
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		<title>By: Concerned</title>
		<link>http://myheartsisters.org/2009/05/28/heart-attack-misdiagnosis-women/#comment-47964</link>
		<dc:creator><![CDATA[Concerned]]></dc:creator>
		<pubDate>Sun, 13 May 2012 20:06:38 +0000</pubDate>
		<guid isPermaLink="false">http://myheartsisters.org/?p=1228#comment-47964</guid>
		<description><![CDATA[Thank you for this website, it has made me aware of the problems that can be faced by women who complain of symptoms that could be related to a heart attack.  

My own experience was on Weds/Thurs AM early hours.  I had taken two Nurofen Express capsules (Ibuprofen) at about 1am for cold symptoms and an hour and a half later woke up with a strange feeling of being drugged, pupils dilated with tingling sensation and numbness of the lips (now I recognise it).  I checked that I had not overdosed, first two of second strip, so not likely, and decided to ring 999 (*911 in North America).  

I was told that it didn&#039;t sound serious, so NHS Direct would call me, by then I was experiencing some aching in the upper mid back and tingling down the right arm into the fingers which made the concerned lady on the other end of the phone send out an ambulance.  The paramedics checked all vital signs which were normal and asked me if I really wanted to go to A&amp;E and I thought perhaps I should.  When I got there, because my signs were good I was sent through to Triage (looked upon as not serious enough for Emergency Medicine) where a GP saw me and said that because my heart sounded good and although I had not had any ECG tests sent me home saying that I had muscular symptoms which caused my aching symptoms and to stop using my computer for a couple of days. 

I therefore had to walk the length of the hospital to get some money to order a taxi home at such an early hour.  I did as I was told, rested, had some buzzing in my ears which I put down to a slightly raised BP when paramedics had arrived, and have been exhausted ever since following exertion.  Reading all of this I am now on the alert!  It has been suggested to me to rule out muscular symptoms and to take it easy.  Now I am not so sure ....]]></description>
		<content:encoded><![CDATA[<p>Thank you for this website, it has made me aware of the problems that can be faced by women who complain of symptoms that could be related to a heart attack.  </p>
<p>My own experience was on Weds/Thurs AM early hours.  I had taken two Nurofen Express capsules (Ibuprofen) at about 1am for cold symptoms and an hour and a half later woke up with a strange feeling of being drugged, pupils dilated with tingling sensation and numbness of the lips (now I recognise it).  I checked that I had not overdosed, first two of second strip, so not likely, and decided to ring 999 (*911 in North America).  </p>
<p>I was told that it didn&#8217;t sound serious, so NHS Direct would call me, by then I was experiencing some aching in the upper mid back and tingling down the right arm into the fingers which made the concerned lady on the other end of the phone send out an ambulance.  The paramedics checked all vital signs which were normal and asked me if I really wanted to go to A&amp;E and I thought perhaps I should.  When I got there, because my signs were good I was sent through to Triage (looked upon as not serious enough for Emergency Medicine) where a GP saw me and said that because my heart sounded good and although I had not had any ECG tests sent me home saying that I had muscular symptoms which caused my aching symptoms and to stop using my computer for a couple of days. </p>
<p>I therefore had to walk the length of the hospital to get some money to order a taxi home at such an early hour.  I did as I was told, rested, had some buzzing in my ears which I put down to a slightly raised BP when paramedics had arrived, and have been exhausted ever since following exertion.  Reading all of this I am now on the alert!  It has been suggested to me to rule out muscular symptoms and to take it easy.  Now I am not so sure &#8230;.</p>
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		<title>By: Margaret</title>
		<link>http://myheartsisters.org/2009/05/28/heart-attack-misdiagnosis-women/#comment-43610</link>
		<dc:creator><![CDATA[Margaret]]></dc:creator>
		<pubDate>Tue, 17 Apr 2012 09:50:33 +0000</pubDate>
		<guid isPermaLink="false">http://myheartsisters.org/?p=1228#comment-43610</guid>
		<description><![CDATA[I am at this moment sitting with pain in my left arm from shoulder to elbow - if I go to use the arm the pain intensifies. I have been having stabbing pains in my chest but they come and go they don&#039;t last very long. I feel like I have eaten too much. I have been to the doctor&#039;s but I feel they are not listening to me.]]></description>
		<content:encoded><![CDATA[<p>I am at this moment sitting with pain in my left arm from shoulder to elbow &#8211; if I go to use the arm the pain intensifies. I have been having stabbing pains in my chest but they come and go they don&#8217;t last very long. I feel like I have eaten too much. I have been to the doctor&#8217;s but I feel they are not listening to me.</p>
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		<title>By: Carolyn Thomas</title>
		<link>http://myheartsisters.org/2009/05/28/heart-attack-misdiagnosis-women/#comment-43298</link>
		<dc:creator><![CDATA[Carolyn Thomas]]></dc:creator>
		<pubDate>Sun, 15 Apr 2012 15:18:44 +0000</pubDate>
		<guid isPermaLink="false">http://myheartsisters.org/?p=1228#comment-43298</guid>
		<description><![CDATA[I think the story that begins this post (male patient with &lt;em&gt;&quot;normal&quot;&lt;/em&gt; cardiac test results being kept overnight for observation while women are being misdiagnosed and sent home) is the most telling illustration of how pervasive this issue is. Thanks for your comment here.]]></description>
		<content:encoded><![CDATA[<p>I think the story that begins this post (male patient with <em>&#8220;normal&#8221;</em> cardiac test results being kept overnight for observation while women are being misdiagnosed and sent home) is the most telling illustration of how pervasive this issue is. Thanks for your comment here.</p>
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		<title>By: Ch411</title>
		<link>http://myheartsisters.org/2009/05/28/heart-attack-misdiagnosis-women/#comment-42893</link>
		<dc:creator><![CDATA[Ch411]]></dc:creator>
		<pubDate>Fri, 13 Apr 2012 03:14:21 +0000</pubDate>
		<guid isPermaLink="false">http://myheartsisters.org/?p=1228#comment-42893</guid>
		<description><![CDATA[Even the name of the heart attack you and I both survived &lt;strong&gt;&#039;the widowmaker&#039; &lt;/strong&gt;tells us that doctors still believe this to be a MAN&#039;S HEART ATTACK. When will E.R. doctors get the message and stop telling women heart pts that they have &lt;em&gt;-pick one-&lt;/em&gt; anxiety depression gall bladder fatigue menopause? ]]></description>
		<content:encoded><![CDATA[<p>Even the name of the heart attack you and I both survived <strong>&#8216;the widowmaker&#8217; </strong>tells us that doctors still believe this to be a MAN&#8217;S HEART ATTACK. When will E.R. doctors get the message and stop telling women heart pts that they have <em>-pick one-</em> anxiety depression gall bladder fatigue menopause? </p>
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		<title>By: Dr. Joe</title>
		<link>http://myheartsisters.org/2009/05/28/heart-attack-misdiagnosis-women/#comment-4024</link>
		<dc:creator><![CDATA[Dr. Joe]]></dc:creator>
		<pubDate>Mon, 22 Aug 2011 14:14:26 +0000</pubDate>
		<guid isPermaLink="false">http://myheartsisters.org/?p=1228#comment-4024</guid>
		<description><![CDATA[[...] under the age of 55 are in fact seven times more likely than men are to be misdiagnosed in mid-heart attack and sent home.  About 5% of autopsies find clinically significant conditions that were missed and [...]]]></description>
		<content:encoded><![CDATA[<p>[...] under the age of 55 are in fact seven times more likely than men are to be misdiagnosed in mid-heart attack and sent home.  About 5% of autopsies find clinically significant conditions that were missed and [...]</p>
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		<title>By: Mary Newman</title>
		<link>http://myheartsisters.org/2009/05/28/heart-attack-misdiagnosis-women/#comment-1875</link>
		<dc:creator><![CDATA[Mary Newman]]></dc:creator>
		<pubDate>Fri, 10 Dec 2010 16:28:02 +0000</pubDate>
		<guid isPermaLink="false">http://myheartsisters.org/?p=1228#comment-1875</guid>
		<description><![CDATA[Thanks for the information you have provided.  

I am a 54 year old woman who one month ago had an experience that was like an electrical shock through the upper body and both arms that lasted just a few minutes.  After that was gone, I was left very weak and anytime I got up to do anything my heart rate would go up and most times my blood pressure would drop. I had indigestion also. This happened on Saturday and I went to see my family doctor on Monday.  He ran an ekg and told me there was signs of a heart attack and sent me to the ER.  

They ran the blood work once, then four hours later and I had a ct scan. Was told it was not heart related, to go home and check with family doctor for stomach issues.  My family doctor ordered a holter moniter and a stress test. 

Before I had either test I had another episode where I could not get my breath and my left arm went numb.  By the time I reached the ER, I was shaking all over. My heart rate goes up all the time if I do anything, but if I lie down it will go to normal.  Again, the ER told me there was nothing, probably anxiety.  

Since then, both my tests have come back with normal results, but I am still getting the rapid heart rate when I do almost everything. If I continue to be active, I will have other symptoms. I have requested an appointment with another doctor because I feel so frustrated.]]></description>
		<content:encoded><![CDATA[<p>Thanks for the information you have provided.  </p>
<p>I am a 54 year old woman who one month ago had an experience that was like an electrical shock through the upper body and both arms that lasted just a few minutes.  After that was gone, I was left very weak and anytime I got up to do anything my heart rate would go up and most times my blood pressure would drop. I had indigestion also. This happened on Saturday and I went to see my family doctor on Monday.  He ran an ekg and told me there was signs of a heart attack and sent me to the ER.  </p>
<p>They ran the blood work once, then four hours later and I had a ct scan. Was told it was not heart related, to go home and check with family doctor for stomach issues.  My family doctor ordered a holter moniter and a stress test. </p>
<p>Before I had either test I had another episode where I could not get my breath and my left arm went numb.  By the time I reached the ER, I was shaking all over. My heart rate goes up all the time if I do anything, but if I lie down it will go to normal.  Again, the ER told me there was nothing, probably anxiety.  </p>
<p>Since then, both my tests have come back with normal results, but I am still getting the rapid heart rate when I do almost everything. If I continue to be active, I will have other symptoms. I have requested an appointment with another doctor because I feel so frustrated.</p>
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		<title>By: sreyanka</title>
		<link>http://myheartsisters.org/2009/05/28/heart-attack-misdiagnosis-women/#comment-1688</link>
		<dc:creator><![CDATA[sreyanka]]></dc:creator>
		<pubDate>Tue, 26 Oct 2010 04:33:57 +0000</pubDate>
		<guid isPermaLink="false">http://myheartsisters.org/?p=1228#comment-1688</guid>
		<description><![CDATA[I am a 40 year old woman who a month ago had a heart attack.. I had the indigestion feeling that was so painful I had to call a friend and she came and said she was calling 911. The paramedics arrived and i was sitting in my chair freezing to death. I couldnt get enough air into my lungs fast enough. I was taken to the ER and it showed that i had had a mild heart attack. I was admitted to the icu and the next day they did a heart cath and found i was 90% blocked. i was told that i had to have a heart bypass and the next day at 5:30 am i was in surgery. 
]]></description>
		<content:encoded><![CDATA[<p>I am a 40 year old woman who a month ago had a heart attack.. I had the indigestion feeling that was so painful I had to call a friend and she came and said she was calling 911. The paramedics arrived and i was sitting in my chair freezing to death. I couldnt get enough air into my lungs fast enough. I was taken to the ER and it showed that i had had a mild heart attack. I was admitted to the icu and the next day they did a heart cath and found i was 90% blocked. i was told that i had to have a heart bypass and the next day at 5:30 am i was in surgery. </p>
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		<title>By: Carolyn Thomas</title>
		<link>http://myheartsisters.org/2009/05/28/heart-attack-misdiagnosis-women/#comment-1554</link>
		<dc:creator><![CDATA[Carolyn Thomas]]></dc:creator>
		<pubDate>Wed, 15 Sep 2010 01:07:40 +0000</pubDate>
		<guid isPermaLink="false">http://myheartsisters.org/?p=1228#comment-1554</guid>
		<description><![CDATA[Hello Wendy,
No wonder you are frustrated. I&#039;m sorry you&#039;re going through this. 

The standard cardiac diagnostic tests are an EKG and cardiac enzyme blood tests, particularly for troponins which are enzymes released into the bloodstream that are usually not measurable unless you&#039;ve had heart muscle damage during a heart attack.  After a cardiac event, troponin levels begin to rise in the blood 4-6 hours after the first symptoms, but can take 24-48 hours to peak. You no doubt already had cardiac enzymes tested yesterday but if your symptoms persist, do not wait for Monday&#039;s appointment: go immediately back to the ER for further tests. And yes, do keep track of every symptom.

Your symptoms may NOT be due to heart problems, but at this point you don&#039;t know for sure. Something is causing them - what is it?  I have met women with atypical heart attack symptoms ranging from a persistent cough to numbness in the lower lip.  I have met countless women who in mid-heart attack were sent home from the ER with &quot;normal&quot; cardiac test results and reassured as you were that it was NOT a heart issue. But diagnosis is often complicated because there are many conditions with distressing symptoms that may mimic heart disease. That&#039;s likely why your doctor appears not to be listening to your concerns - he may be stumped by all these &quot;normal&quot; test results. So much of medicine is just trying to eliminate  what the problem ISN&#039;T.

You absolutely did the right thing by going to the ER immediately after yesterday&#039;s symptoms, and again today going to see your doctor.  Please keep going back if symptoms persist. You know your body - you know when something is &quot;not right&quot;.

It&#039;s unfortunately common for women to try to wait it out, see if things get better, keep quiet, not make a fuss.  Don&#039;t do that!!

Best of luck to you,
C.]]></description>
		<content:encoded><![CDATA[<p>Hello Wendy,<br />
No wonder you are frustrated. I&#8217;m sorry you&#8217;re going through this. </p>
<p>The standard cardiac diagnostic tests are an EKG and cardiac enzyme blood tests, particularly for troponins which are enzymes released into the bloodstream that are usually not measurable unless you&#8217;ve had heart muscle damage during a heart attack.  After a cardiac event, troponin levels begin to rise in the blood 4-6 hours after the first symptoms, but can take 24-48 hours to peak. You no doubt already had cardiac enzymes tested yesterday but if your symptoms persist, do not wait for Monday&#8217;s appointment: go immediately back to the ER for further tests. And yes, do keep track of every symptom.</p>
<p>Your symptoms may NOT be due to heart problems, but at this point you don&#8217;t know for sure. Something is causing them &#8211; what is it?  I have met women with atypical heart attack symptoms ranging from a persistent cough to numbness in the lower lip.  I have met countless women who in mid-heart attack were sent home from the ER with &#8220;normal&#8221; cardiac test results and reassured as you were that it was NOT a heart issue. But diagnosis is often complicated because there are many conditions with distressing symptoms that may mimic heart disease. That&#8217;s likely why your doctor appears not to be listening to your concerns &#8211; he may be stumped by all these &#8220;normal&#8221; test results. So much of medicine is just trying to eliminate  what the problem ISN&#8217;T.</p>
<p>You absolutely did the right thing by going to the ER immediately after yesterday&#8217;s symptoms, and again today going to see your doctor.  Please keep going back if symptoms persist. You know your body &#8211; you know when something is &#8220;not right&#8221;.</p>
<p>It&#8217;s unfortunately common for women to try to wait it out, see if things get better, keep quiet, not make a fuss.  Don&#8217;t do that!!</p>
<p>Best of luck to you,<br />
C.</p>
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		<title>By: Wendy</title>
		<link>http://myheartsisters.org/2009/05/28/heart-attack-misdiagnosis-women/#comment-1553</link>
		<dc:creator><![CDATA[Wendy]]></dc:creator>
		<pubDate>Tue, 14 Sep 2010 22:26:09 +0000</pubDate>
		<guid isPermaLink="false">http://myheartsisters.org/?p=1228#comment-1553</guid>
		<description><![CDATA[I am so frustrated.  

Let me start by saying I am a non smoker non drinker no known health problems and rarely have to go to the doctor.  (by the way I hate going to the doctor because I feel he really doesn&#039;t listen)  

Yesterday while I was at work I got dizzy my hands and forehead and face went numb and Then within 10 minutes I sounded drunk and was slurring my words unable to get the words out.  I went to the ER because I thought I might be having a stroke.  The ER did an ekg Chest xray Cat scan Echo cardiograham. The Cat scan had a spot on it they didn&#039;t know what it was so they sent me to for an MRI. and they did blood work.  Everything came back normal. The neurologist said he couldn&#039;t see anything on the tests but it could be from a complicated migraine. Even without having a head ache.  or it could be MS symptoms but they didn&#039;t see that and there is no family history He doesn&#039;t think it was a stroke because nothing showed on the test and both sides of my face were affected not just one.   He did say my B12 level was low--219 so he ordered a b-12 shot.  but sent me home saying I should take baby aspirin. and get a shot once a month and follow up with him in two weeks.

Today just after eating lunch my left arm went numb and was tingling and I have been nauseous all day.  I called my doctor who told me to come in and he basically said we have pretty much done every test there is to do  he asked me what the neurologist said and then basically repeated it to me saying the b12 or the complicated migraine probably caused my problems and if the numbness persisted they could do a nerve test on my arm but to just watch it and keep track to see if there is a pattern.   

I am really concerned because Heart disease runs very strong in my family  My dad had a triple bypass and a stroke his sisters and brother dies of heart failure(2) and an annurism.  When I told him this was my concern because I have had chest pains in the past he said yes I can see in your chart you have had some stress.  I told him not anything unusual--he had it in my file my problems were from stress  I told him only the normal stress of a full time working mom.  he said I think you can be confident it isn&#039;t your heart but I am not confident. I feel anxious about it because I think he isn&#039;t really listening to my concerns.  I have an appointment with a different doctor Monday are there any tests I should ask about or should I just wait and keep track of my symptoms?]]></description>
		<content:encoded><![CDATA[<p>I am so frustrated.  </p>
<p>Let me start by saying I am a non smoker non drinker no known health problems and rarely have to go to the doctor.  (by the way I hate going to the doctor because I feel he really doesn&#8217;t listen)  </p>
<p>Yesterday while I was at work I got dizzy my hands and forehead and face went numb and Then within 10 minutes I sounded drunk and was slurring my words unable to get the words out.  I went to the ER because I thought I might be having a stroke.  The ER did an ekg Chest xray Cat scan Echo cardiograham. The Cat scan had a spot on it they didn&#8217;t know what it was so they sent me to for an MRI. and they did blood work.  Everything came back normal. The neurologist said he couldn&#8217;t see anything on the tests but it could be from a complicated migraine. Even without having a head ache.  or it could be MS symptoms but they didn&#8217;t see that and there is no family history He doesn&#8217;t think it was a stroke because nothing showed on the test and both sides of my face were affected not just one.   He did say my B12 level was low&#8211;219 so he ordered a b-12 shot.  but sent me home saying I should take baby aspirin. and get a shot once a month and follow up with him in two weeks.</p>
<p>Today just after eating lunch my left arm went numb and was tingling and I have been nauseous all day.  I called my doctor who told me to come in and he basically said we have pretty much done every test there is to do  he asked me what the neurologist said and then basically repeated it to me saying the b12 or the complicated migraine probably caused my problems and if the numbness persisted they could do a nerve test on my arm but to just watch it and keep track to see if there is a pattern.   </p>
<p>I am really concerned because Heart disease runs very strong in my family  My dad had a triple bypass and a stroke his sisters and brother dies of heart failure(2) and an annurism.  When I told him this was my concern because I have had chest pains in the past he said yes I can see in your chart you have had some stress.  I told him not anything unusual&#8211;he had it in my file my problems were from stress  I told him only the normal stress of a full time working mom.  he said I think you can be confident it isn&#8217;t your heart but I am not confident. I feel anxious about it because I think he isn&#8217;t really listening to my concerns.  I have an appointment with a different doctor Monday are there any tests I should ask about or should I just wait and keep track of my symptoms?</p>
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		<title>By: Carolyn Thomas</title>
		<link>http://myheartsisters.org/2009/05/28/heart-attack-misdiagnosis-women/#comment-1331</link>
		<dc:creator><![CDATA[Carolyn Thomas]]></dc:creator>
		<pubDate>Sun, 20 Jun 2010 14:58:07 +0000</pubDate>
		<guid isPermaLink="false">http://myheartsisters.org/?p=1228#comment-1331</guid>
		<description><![CDATA[Hello dg - when I was at Mayo Clinic five months after my own heart attack, I met dozens of women who told similar stories of being sent home from the Emergency Department with misdiagnoses ranging from acid reflux to anxiety attacks to gall bladder problems. And of course many docs believe that menopause itself is a nice little all-purpose diagnosis for whatever ails you!  

I think that we need to see two major shifts here: #1 - women need to be far more assertive about demanding quality care when we know that something is seriously wrong, and #2 - medical professionals need far more education on the realities of women&#039;s heart disease.
Cheers,
C.]]></description>
		<content:encoded><![CDATA[<p>Hello dg &#8211; when I was at Mayo Clinic five months after my own heart attack, I met dozens of women who told similar stories of being sent home from the Emergency Department with misdiagnoses ranging from acid reflux to anxiety attacks to gall bladder problems. And of course many docs believe that menopause itself is a nice little all-purpose diagnosis for whatever ails you!  </p>
<p>I think that we need to see two major shifts here: #1 &#8211; women need to be far more assertive about demanding quality care when we know that something is seriously wrong, and #2 &#8211; medical professionals need far more education on the realities of women&#8217;s heart disease.<br />
Cheers,<br />
C.</p>
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		<title>By: dg</title>
		<link>http://myheartsisters.org/2009/05/28/heart-attack-misdiagnosis-women/#comment-1326</link>
		<dc:creator><![CDATA[dg]]></dc:creator>
		<pubDate>Sat, 19 Jun 2010 17:00:22 +0000</pubDate>
		<guid isPermaLink="false">http://myheartsisters.org/?p=1228#comment-1326</guid>
		<description><![CDATA[Thanks for the above.  You&#039;ve made me feel a whole lot better, knowing it&#039;s not just me.  

Here in the UK, I&#039;ve just found out that I&#039;ve got a small heart defect, and minor heart attacks have been wrongly diagnosed for 14 years!  

It seems I started to get them when I developed an underactive thyroid, which raised my blood pressure from normally low to, initially, high.  They got it down to normal, but this was high for me and the heart attacks started.  

I was told it was indigestion, gastric reflux, a funny turn - and doctor after doctor (including a hospital consultant) failed to recognise standard signs of a heart attack.  It was only recently when I managed to get to the hospital during an attack that they realised what it was, gave me an angiogram and found the problem.]]></description>
		<content:encoded><![CDATA[<p>Thanks for the above.  You&#8217;ve made me feel a whole lot better, knowing it&#8217;s not just me.  </p>
<p>Here in the UK, I&#8217;ve just found out that I&#8217;ve got a small heart defect, and minor heart attacks have been wrongly diagnosed for 14 years!  </p>
<p>It seems I started to get them when I developed an underactive thyroid, which raised my blood pressure from normally low to, initially, high.  They got it down to normal, but this was high for me and the heart attacks started.  </p>
<p>I was told it was indigestion, gastric reflux, a funny turn &#8211; and doctor after doctor (including a hospital consultant) failed to recognise standard signs of a heart attack.  It was only recently when I managed to get to the hospital during an attack that they realised what it was, gave me an angiogram and found the problem.</p>
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		<title>By: jb</title>
		<link>http://myheartsisters.org/2009/05/28/heart-attack-misdiagnosis-women/#comment-26</link>
		<dc:creator><![CDATA[jb]]></dc:creator>
		<pubDate>Fri, 29 May 2009 02:49:06 +0000</pubDate>
		<guid isPermaLink="false">http://myheartsisters.org/?p=1228#comment-26</guid>
		<description><![CDATA[Thanks for this on heart disease mis-diagnosis. I look forward to each new essay, you clearly have natural ability for writing!]]></description>
		<content:encoded><![CDATA[<p>Thanks for this on heart disease mis-diagnosis. I look forward to each new essay, you clearly have natural ability for writing!</p>
]]></content:encoded>
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