Dear Carolyn: “I had both acid reflux and a heart attack at the same time!”

24 Sep

by Carolyn Thomas  ♥  @HeartSisters

As I’ve repeatedly insisted, my Heart Sisters blog readers are the smartest, kindest, sharpest and best-looking readers out there in the blogosphere. . .  Today starts a series of Dear Carolyn posts starring my readers, each of whom has contacted me over the years to share, in her own words, the unique story of how she became a heart patient. Most of these, as you’ll discover if you keep up with this series, involve an “aha!” moment, or a plot twist that I didn’t see coming, or a lesson that just strikes me as downright useful for other women to know. And if you too have a personal heart story you think needs to be shared with the world (or at least the part of our world reading Heart Sisters each week), please share yours by contacting me here.

Today’s tale focuses on one of my favourite themes in women’s heart health: it’s possible to have both acid reflux (or any other chronic condition) AND a heart condition all at the same time. It’s from Debbie Orth, who lives near Cleveland, Ohio. (That’s Debbie in olive green at the centre of the photo above, having fun on a family cruise while celebrating her parents’ 50th wedding anniversary, just seven months post-heart attack!)

“Dear Carolyn,

“I do not remember how I came across this website, other than it must have been after I suffered a heart attack at the age of 48.

“I had a 100% blockage of my LAD.* (Carolyn’s note: see glossary at the end for translations of some medical terms in this letter).  I had symptoms prior to my heart attack which were diagnosed as acid reflux after having an endoscopy and colonoscopy. Five weeks after that diagnosis, I unlocked my front door and called 911. The paramedics and hospital saved my life by initiating the STEMI protocol. Had I not called 911 when I did, I would not be here today. It was also determined that I was probably having mild heart attacks leading up to the massive one I had.

“Interestingly, I did have acid reflux and as it turned out, heart issues, too. But I do feel the first physician should have explored more.

“The symptoms I had were not classic, but the day before I had the heart attack, I felt like crap. I started feeling something was terribly wrong. Again, they were not classic symptoms. Pressure in my sternum and a little tingling in my hand. What set off the alarm for me was my color. It was ashen, and I remember saying out loud to myself, “I’m in trouble.” The next morning was when I had the heart attack.

“That was back on December 5, 2014. That day I made a commitment to myself, family and friends that I would do everything I could not to let it happen again. I had my last cigarette that day, started cardio exercise five days a week once I was cleared by cardiac rehabilitation, and I eat healthier now. I am a big walker/hiker, and try to take a couple of 5 -6 mile hikes every week.

“I have gone through many ups and downs, doctors’ appointments, testing, therapy with a counselor, and finally I now feel like the ground I am on is a little firmer. I will never forget what happened. Forever changed and grateful to be alive.

“I follow Heart Sisters on Facebook and share your posts with friends, hoping we can keep women better informed on heart disease. Far too many women lose their lives to heart disease when there are so many treatments available.

“I want to thank you for the wonderful information and resources you provide on the Heart Sisters blog. Wishing you all the best,”


Debbie Orth

Thanks, Debbie!

Q: Do you too live with more than one serious condition that sometimes makes it hard to figure out which one’s acting up?

.

*Glossary of terms in this post:

  • LAD: left anterior descending coronary artery, one of the largest of the arteries supplying blood to the heart muscle
  • STEMI: ST elevation myocardial infarction, the most serious kind of heart attack, caused by a prolonged period of blocked blood supply to the heart muscle
  • acid reflux: the backward flow of stomach acid into your esophagus (the tube that connects the throat and stomach) causing a feeling of burning in your chest (also called heartburn)
  • endoscopy: a procedure used to visually examine your upper digestive system with a tiny camera on the end of a long, flexible tube
  • colonoscopy: a test that allows doctors to look at the inner lining of your large intestine
  • sternum: a long, narrow, flat bone at the front centre of your chest (also called the breastbone)
  • For lots more patient-friendly, jargon-free translations of confusing terms, please visit my Heart Sisters glossary
 

10 Responses to “Dear Carolyn: “I had both acid reflux and a heart attack at the same time!””

  1. Linda Knight September 25, 2017 at 5:00 am #

    I’m so glad I found this site.

    Liked by 1 person

  2. Lois Bouchard September 24, 2017 at 5:37 pm #

    I am curious to know that in your case Carolyn, when you were misdiagnosed with your heart attack, if you ever reported the doctor to the Hospital Administration, Risk Management or write a formal complaint to the state medical board?

    I feel that if more women stood up to doctors who are undertreating or misdiagnosing, they may take women a lot more seriously. It is time to ask as many questions as need be and never feel intimidated by arrogance.

    I have spent years working for directors of cancer research and neonatal medicine at UNC Hospitals. One thing I have learned is that treating patients is more an ‘art than a science’. You are your best advocate and the more you demand answers the more they will take you seriously.

    I am off to Emory University in Atlanta, GA this week. I was referred to a Dr. Puja Mehta who is a cardiologist and specializes in women’s heart disease and microvascular disease. She has written an abstract about ‘Managing Angina Pain’, which is included in a medical book I am reading, “Chest Pain With Normal Coronary Arteries:. It is a good book but a bit hard for the lay person to comprehend. She mentions the drug ‘ranolazine’. Does anyone take this drug for angina and does it help?

    I tried to get my cardiologist here to read this excellent book as he knows nothing about cardiac MVD in women. He told me he couldn’t find the book in the Duke library. I told him to try Amazon. That’s how pathetic this doctor is. His nurse (who never met me) told me that they don’t believe I have cardiac MVD, because I don’t get migraine headaches. In all my research, I never encountered the connection between migraine headaches and cardiac MVD. Another nurse told me in front of my husband, that she never heard of Cardiac Syndrome X. This Duke doctor would not even authorize a handicap placard for me because he didn’t believe I had shortness of breath while walking distances or inclines to my car. So, hold doctors accountable and don’t allow them to mistreat you. If they do, than move on but not before you put in writing the reasons why.

    Lois Bouchard
    Cary, NC

    Liked by 1 person

    • Carolyn Thomas September 24, 2017 at 6:54 pm #

      Hello Lois – no, I didn’t report that ER physician to my hospital. Many people have asked me that question. I’d like to think I would complain now if this same scenario were playing out today, but the truth is that I was very ill at the time, with very serious cardiac symptoms. I could barely function, never mind file an official complaint! Also, a huge part of the problem was my own “treatment-seeking delay behaviour” (because a man with the letters M.D. after his name had told me ‘it’s not your heart’). I was simply too embarrassed to go back to the ER despite increasingly horrific symptoms. Had I done so immediately, I believe my outcome would have been far better, misdiagnosed or not. On some level, I knew I could hardly complain about that doc while admitting that I had repeatedly refused to return for help after that first trip to the ER.

      In my experience, many doctors are not as informed about MVD as they should be. Your doc’s unlikely to order that book, so save your breath. There have been a number of studies that do link migraine with all forms of women’s cardiovascular disease – here’s a sample from the BMJ with a 20-year follow up that cites a number of previous studies too. But this does NOT mean, of course, that you don’t have MVD just because you don’t have migraines. Personally, I have never experienced a migraine (and I have MVD) but that’s just a personal anecdotal report, not science! Best of luck to you…

      Like

  3. Pauline Lambert Reynolds September 24, 2017 at 7:14 am #

    Dear Carolyn,
    I have had both acid reflux and Coronary Artery Disease for at least 12 years now. So far, I have been able to tell the difference, even after 12 stents! If I have the slightest hint of chest pressure, I take a Tums. If I burp in 5 minutes, I’m OK. If it continues and I don’t burp, I take nitro. So goes my idyllic existence.

    Liked by 1 person

    • Carolyn Thomas September 24, 2017 at 7:21 am #

      Oh, Pauline. I laughed right out loud at your ‘idyllic existence’! You’ve got it down to a science by now…

      Like

  4. Meghan September 24, 2017 at 6:26 am #

    So glad everything worked out well for Debbie! I have had 2 blockages in my LAD, one 90% and one 99%, and have two stents, luckily avoiding a heart attack both times.

    Ever since learning about acid reflux and heart symptoms, I become very scared when I do have acid reflux, which is not a lot — but if it’s severe, I worry that it’s my heart. The last time I did cardiac rehab, after the second stent, I had a lot of little minor chest pains and ended up having to stop doing rehab several times while my doctor evaluated the symptoms. I wore a nitro patch for awhile. Finally my cardiologist told me to take famotidine (generic for Pepcid) every single day (I had been using this on an occasional basis), and the little pains totally stopped. I had told her that taking nitro helped when I felt the pains, and she told me that nitro can also help with stomach issues — never heard that before, wondering how true that is, but somehow she figured out that I should take the famotidine, which really helped so it must be true. This was last winter — I don’t have those little chest pains anymore. (I no longer take the acid reducer every day now, only when I know something may give me heartburn.) This is just another example of how the whole body works together and one thing influences another, I guess.

    Thank you, Carolyn, for telling these stories — I love hearing other people’s real, honest stories. So good to know we are not alone on this journey of heart disease!

    Liked by 1 person

    • Carolyn Thomas September 24, 2017 at 7:14 am #

      Thanks Meaghan! You are so right – everything in the human body can influence everything else in the body. I’m glad you mentioned acid reflux meds. Recent studies have warned heart patients NOT to take the acid reflux drugs called proton-pump inhibitors (like Prilosec, Nexium and Prevacid) that have been shown to increase risk of heart attack in moderate/high-risk patients. Your famotidine/Pepcid is a different drug (H2) and no cardiac issues have been observed.

      I have heard that, oddly, nitro taken for angina can also simultaneously affect symptoms of acid reflux in some cases (specifically symptoms of esophageal spasm) so that might be why you felt some relief with nitro, although I’m guessing that nitro wouldn’t generally be prescribed for acid reflux.

      Like

  5. gerriluce1961 September 24, 2017 at 6:15 am #

    Hi Carolyn.

    Thank you for all the work you put into this blog. I was diagnosed with Prinzmetal’s Angina several years ago after seeking a second opinion from a well-respected female cardiologist at a women’s health center in NYC after a male cardiologist diagnosed me with anxiety in about 5 minutes. I have a history of anorexia and depression, which no doubt biased this hasty diagnosis. But this cardiologist took the time to look beyond my mental health history and inquire about my co-occuring conditions of migraines and Raynaud’s, which helped her make the correct diagnosis.

    At the beginning of the year, I went to my local ER for chest pain. Everything checked out, but they urged me to get a stress test. I saw this Dr. and I was wheezing at the time (I also have asthma), so she directed me to my pulmonologist. She continues to insist that the issue is with my lungs. Over the course of the last six months, I’ve began to experience symptoms that I feel could possibly be heart failure – the most recent being pitting edema in my legs which is evident after a day of sitting at work. The last time, my legs were so swollen that my physical therapist (who I see once a week on a regular basis) was literally freaking out. It was she who mentioned heart failure and when I looked it up – all the symptoms now add up. My experience with doctors is that if they don’t see it when you’re in the office – it didn’t happen, i.e. the pitting edema.

    Have you – or any other of your readers had a similar problem and how did you handle it?

    Thanks.

    Gerri

    Liked by 2 people

    • Carolyn Thomas September 24, 2017 at 6:48 am #

      Hi Gerri – yours is an interesting case (a complex medical history of anorexia, depression, asthma and now heart disease). I’m not a physician, but I can tell you that many overlapping symptoms can be common in more than one condition. The key is to spot the symptoms that don’t ‘belong’ with the fast and easy diagnosis (as your first cardiologist demonstrated). The question to ask your pulmonologist: are pitting edema and swollen legs typical symptoms of asthma? And seek a second opinion if symptoms continue or get worse.

      Yes, I’ve experienced something similar when my heart attack was misdiagnosed in the E.R. as acid reflux – despite textbook symptoms. Even I knew that pain down your left arm is NOT a sign of simple heartburn. But shortly after I asked, “But Doc, what about this pain in my arm?”, the E.R. nurse told me to stop asking questions of the doc. (“He’s a very good doctor and he does not like to be questioned!”)

      Like

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