Signals, noise, context – and your doctor’s brain

     .    . Emergency physician, professor, author, and patient safety expert Dr. Pat Croskerry

by Carolyn Thomas      @HeartSisters 

Emergency physician Dr. Pat Croskerry tells the story of the day he misdiagnosed a patient who was experiencing unstable anginachest pain caused by coronary artery disease, and often a warning sign of oncoming heart attack. But this is what he’d said before sending that patient home:

“I’m not at all worried about your chest pain. You probably overexerted yourself and strained a muscle. My suspicion that this is coming from your heart is about zero.”

In a later interview with Dr. Jerome Groopman (author of a book I love called How Doctors Think), Dr. Croskerry explained how easily that misdiagnosis happened: Continue reading “Signals, noise, context – and your doctor’s brain”

Stents vs. bypass surgery vs. TRUST

by Carolyn Thomas        @HeartSisters

In 2018, Dr. Dhruv Khullar warned his colleagues at an American Board of Internal Medicine conference that patients need answers on three dimensions of trust:

  1. Competence:Do you know what you’re doing?”
  2. Transparency:Will you tell me what you’re doing?”
  3. Motive:Are you doing this to help me or yourself?”        .     .

Continue reading “Stents vs. bypass surgery vs. TRUST”

Coronary stents: interventions that come with a cost

by Carolyn Thomas       @HeartSisters

Remember last month when I covered the topic of stretch pain” in heart patients who have had a coronary stent implanted?

To recap, temporary post-stent stretch pain in the chest is due to the dilation of an artery when a metal stent is being implanted inside that artery, and it typically occurs in about 40 per cent of stent patients.  A number of you wrote in with some variation of this question: “Is it still stretch pain if it’s happening months afterwards?”

And now a new study published in the Journal of the American College of Cardiology  suggests that something entirely different might be going on.2 .      .      , Continue reading “Coronary stents: interventions that come with a cost”

Cognitive dread: the painful uncertainty of waiting

by Carolyn Thomas      @HeartSisters 

I live on an island, so we’re often dependent on the ferries that carry islanders to the mainland and back. And because this is Canada’s west coast, high winds or rough seas can very occasionally cause sudden sailing delays or outright cancellations. When this happens, we often don’t know when sailings will resume, and nobody can tell us. Uncertainty like this about what daily life will bring includes both the routinely ordinary (what’s causing this traffic jam?) and the potentially important (when will my test results come in? This state of uncertainty is what psychologists often call “cognitive dread”.    . Continue reading “Cognitive dread: the painful uncertainty of waiting”

Fun factoids about peppers, pigs and your heart

by Carolyn Thomas      @HeartSisters 

Whenever I do my “Heart-Smart Women”  public presentations, I bring along a unique prop. To help me demonstrate to my audiences what a woman’s heart looks like, I pull out a red bell pepper. Yes. A pepper.

When I shop for my prop at my local grocery store, I look for just the right one: a nice healthy red colour, slightly pointy at the bottom, about the size of my clenched fist, and I weigh it at the produce department scale looking for one that weighs about 250 grams.

But am I wrong about those comparisons to the heart?        . Continue reading “Fun factoids about peppers, pigs and your heart”