As part of my Dear Carolyn series of posts featuring my readers’ unique stories about becoming a heart patient, this one involves a plot twist that, sadly, sounds maddeningly familiar. It also involves a remarkable coincidence: a married couple who have their heart attacks eight days apart! Today’s tale focuses on one of my favourite themes in women’s heart health: being misdiagnosed with acid reflux during a heart attack, and it stars my longtime reader, Kathleen:
“I arrived in the ER at around 9:30 p.m. on a Friday with pain in my chest, arms and back. The ER physician told me my EKG was ‘normal’, in a tone that suggested I was wasting his time.
“I received a GI cocktail* (Carolyn’s note: see glossary at the end for translations of some terms in Kathleen’s letter) followed almost immediately by nitro. My chest pain was relieved, and the physician asked which remedy I thought had made the difference. I told him they were given back-to-back, so how was I to know? (I was also currently on Omeprazole for ongoing heartburn, and aspirin having had breast cancer in the past; I’d read that it can slow tumor growth, which the doctor was aware of.)
“Fast forward two hours. The ER director stopped in to see how I was doing. I told her I was fine and waiting for discharge. She asked if my cardiac enzyme blood test results were back. I said no, as no labs were done. Within five minutes, they were drawing my blood.
“Shortly after that, the ER doc came back in and said, very irritatingly, ‘Your troponin level is elevated!’ (In my head I was like, ‘I’m sorry?’) Suddenly, there was a cardiologist along with seven people around my bed asking where my husband was because I was having a heart attack. Luckily, he was able to get there quickly just as I was being loaded into the elevator. Like you, I had the ‘widow maker’ heart attack, caused by a 99% blocked artery.
“Fast forward to Saturday. My husband came into the house complaining of arm and jaw pain. I immediately called 911 (much to his chagrin). I asked which ER doc was on duty, and, thankfully, it wasn’t the same one. Again, his EKG was normal. But this doctor repeated the test every 10 minutes and his blood tests were drawn immediately. Within an hour, my husband was in the cath lab. He ended up with a stent and will be monitored.
“Another interesting note: My husband and I had two different cardiologists. My attack was on a Friday, I was discharged on Sunday and was told I could return to work the next day.
“My husband had his attack on a Saturday and was released on Monday. His cardiologist told him to take five to six weeks off work. (My husband works at a desk job, like myself).
“I have worked in hospitals for over 25 years and know enough to question things that don’t seem quite right. Most people don’t.
“Please continue your Heart Sisters work – we need more women like you!”
NOTE from CAROLYN: This story helps to illustrate what can too often happen when women’s first cardiac diagnostic tests come back “normal“, as Kathleen’s EKG was (and as mine was as well in 2008). But unlike Kathleen, when her husband’s EKG was at first interpreted as “normal” too, his cardiac enzyme blood levels were immediately and repeatedly tested. Had the ER Director not stopped to chat with her two hours after her arrival at the ER, she would have been discharged home in mid-heart attack.
Women should NOT have to count on a coincidental accident to get appropriate testing and diagnoses. And don’t even get me started on the preposterous differences in back to work readiness advice!
Thank you Kathleen! ♥
*Definitions, in order:
- GI cocktail – a mixture of medications often given in a hospital’s Emergency Department to help doctors diagnose (or rule out) a gastro-intestinal problem
- nitro (nitroglycerin) – a medication used to address cardiac chest pain
- Omeprazole – a medication used to treat symptoms of gastroesophageal reflux disease (GERD) or other conditions caused by excess stomach acid
- troponin – a type of cardiac enzyme found in heart muscle, and released into the blood when there is damage to the heart (for example, during a heart attack). A positive blood test that shows elevated troponin is the preferred test for a suspected heart attack because it is more specific for heart injury than other blood tests.
- widowmaker – a type of heart attack attack involving a blockage in the left main coronary artery or in the left anterior descending coronary artery, preventing adequate blood flow to large areas of the heart muscle. If blood flow through these arteries is abruptly and completely blocked, it can cause a massive heart attack that can lead to sudden death. The archaic word itself implies that only men experience widowmaker heart attacks; they don’t, after all, call it the ‘widowermaker’ when they happen to women, do they?
- For more helpful translations of cardiology terms, visit my patient-friendly, jargon-free Heart Sisters glossary.
And if you too have a personal heart disease story with a plot twist that you think should be shared with the world as a “Dear Carolyn” feature (or at least the part of our world that reads Heart Sisters each week), please share your own by contacting me here.
#2 NOTE from CAROLYN: I wrote much more about the cardiology gender gap in Chapter 3 of my book, “A Woman’s Guide to Living with Heart Disease”. You can ask for it at your local library or bookshop or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use the code HTWN to save 20% off the list price).
Q: Has your hubby been treated better/quicker/differently than your own similar medical problem was?