Category: Diagnosing – and misdiagnosing

– posts here focus on how difficult it often is to get an accurate heart disease diagnosis in women

When your doctor mislabels you as an “anxious female”

~ Carolyn Thomas ~ 154 Comments

by Carolyn Thomas  ♥ @HeartSisters

Take it from me: the only thing worse than a heart attack is being misdiagnosed and sent home from hospital while you’re having it. And for women in particular, this is a tragically all-too-common reality.  Research on cardiac misdiagnoses reported in The New England Journal of Medicine(1), for example, looked at more than 10,000 heart patients (48% of them women) who had gone to their hospital Emergency Departments with chest pain or other significant heart attack symptoms. Women younger than 55 were SEVEN TIMES more likely to be misdiagnosed and turned away from the E.R. than their male counterparts.

The consequences of this reality for women were enormous: being sent home from the hospital in mid-heart attack doubled their chances of dying.

Some of the most popular cardiac misdiagnoses that heart attack survivors have told me about include physician guesses like indigestion, menopause, stress, gall bladder issues, exhaustion, pulled muscles, dehydration and more. But perhaps the most distressing misdiagnosis to trip from the lips of an Emergency Department physician is “anxiety”. This one single word is instantly both dismissive and embarrassing. And worse, to have the diagnosis of “anxious female” recorded permanently on a woman’s chart virtually guarantees a definitive psychiatric stereotype for all future medical visits.   Continue reading “When your doctor mislabels you as an “anxious female”” →

Did you really need that coronary stent?

~ Carolyn Thomas ~ 9 Comments

by Carolyn Thomas  ♥ @HeartSisters

balloon-angioplastyA New York study has revisited the issue of stent-happy cardiologists implanting the tiny metal devices that help prop open – or revascularize – blocked coronary arteries. Essentially, this study(1) suggests that two-thirds of the justifications for this procedure in non-emergency patients were either “uncertain” or “inappropriate“. For any heart patient who has ever been told by those with the letters M.D. after their names that this type of cardiac intervention was recommended, it’s yet more troubling news. And the fact that this issue simply will not go away makes me wonder why cardiologists themselves are keeping suspiciously mum about the controversy.

When cardiologists do speak up, not surprisingly, many hasten to pre-emptively defend their interventional colleagues. An editorial that accompanied this study’s publication in the Journal of the American College of Cardiology, for example, explained:

“There are certain to be patients rated as ‘inappropriate’ for which almost all competent cardiologists would recommend intervention.”

In other words, pay no attention to the man behind the curtain.  Continue reading “Did you really need that coronary stent?” →

Those curious cardiac enzymes

~ Carolyn Thomas ~ 36 Comments

by Carolyn Thomas  ♥  @HeartSisters

When I showed up in the Emergency Department with textbook heart attack symptoms – central chest pain, nausea, sweating and pain radiating down my left arm – the hospital staff snapped to work and immediately ordered a flurry of diagnostic tests. These included an EKG (ECG, or electrocardiogram), blood tests, chest x-ray and a treadmill stress test. But all test results came back “normal”. I was then told that I was in the “right demographic” for acid reflux before being sent home – less than five hours after the onset of symptoms.

I left hospital that morning feeling terribly embarrassed for having made such a fuss over just a little case of indigestion.  It was only much later – after finally being correctly diagnosed, taken directly from the E.R. to O.R. and admitted to the cardiac intensive care unit for a myocardial infarction (MI, or heart attack) caused by a fully occluded Left Anterior Descending coronary artery – when I learned that my first “normal” blood tests may have been far less “normal” than I was told.  Continue reading “Those curious cardiac enzymes” →

A second opinion from Dr. Google

~ Carolyn Thomas ~ 25 Comments

by Carolyn Thomas   ♥  @HeartSisters

I’ve often suspected that if only the E.R. doctor who misdiagnosed me with indigestion had bothered to just Google my cardiac symptoms (chest pain, nausea, sweating and pain radiating down my left arm), he and Dr. Google would have almost immediately hit upon my correct diagnosis: myocardial infarction, or heart attack. But instead, he pronounced that I was “in the right demographic” for acid reflux. I was sent home that day feeling horribly embarrassed for having made a fuss over nothing but a case of indigestion. As time went by, however, and my debilitating symptoms became truly unbearable, I turned to Dr. Google.

And that’s why I forced myself, despite my embarrassment, to return to the E.R. – but with the pronouncement of that first E.R. doc still ringing in my ears:

“It is NOT your heart!”

Many physicians out there, however, are not happy when their patients consult Dr. Google to research troubling symptoms like mine. Continue reading “A second opinion from Dr. Google” →