When routine tasks trigger heart symptoms

by Carolyn Thomas  @HeartSisters

household-choresHeart disease is a strange animal indeed. Our very first symptoms can range from mild shortness of breath on exertion to sudden death – and almost every possible symptom in between.  My own were those of the textbook Hollywood Heart Attack (crushing central chest pain, nausea, sweating, and pain down my left arm) – yet I was sent home by Emergency Department staff with a misdiagnosis of indigestion – feeling very, very embarrassed for having made such a fuss over nothing.  It took two weeks to be finally correctly diagnosed with myocardial infarction (heart attack) caused by a 95% blockage of my Left Anterior Descending Coronary artery. And it took several more months – and another trip back to hospital – to figure out what was causing ongoing distressing symptoms that were ultimately diagnosed as Inoperable Coronary Microvascular Disease (MVD) or dysfunction of the smaller coronary arteries.

But MVD is very tricky to diagnose because most standard coronary artery disease diagnostic tests – the kind that work so well at  identifying big fat blockages in our larger arteries – may not be capable of catching it.  Continue reading “When routine tasks trigger heart symptoms”

How do patients know if their docs “will never be good”?

by Carolyn Thomas    @HeartSisters

It all started when cardiologist Dr. William Dillon of Louisville, Kentucky made this observation on his Twitter page about doing cardiac catheterization procedures:

As a two-time veteran of transradial (wrist) caths*, I felt just a wee bit alarmed by the last line of his tweet. We heart patients tend to get a wee bit alarmed by implications that those we trust may “never be good” at what they’ve just done to us, as described by the very people who work alongside them – those known as interventional cardiologists.

I felt similarly alarmed, by the way, during the recent FDA recall of defective Riata cardiac defibrillator leads when Dr. Laurence Epstein of Harvard’s Brigham and Women’s Hospital told Heartwire interviewers that ICD leads  are sometimes “implanted poorly”, bluntly adding:

“You can’t account for knuckleheads putting them in. Some lead failures are going to be expected . . . Others fail because people put them in in horrible ways.”   Continue reading “How do patients know if their docs “will never be good”?”

Inside your heart – as captured by National Geographic

Here’s how your heart looks during a coronary angiography procedure. The white/yellow blood vessels are bringing oxygenated blood to the working muscles of the heart.  (See link below to the whole slide show).

Coronary angiography (also called cardiac catheterization) is sometimes referred to as the ‘gold standard’ of diagnostics for heart patients. The procedure involves threading a tiny catheter through an artery in the wrist or groin and pushing it up, up, up right into the beating heart. It’s considered to be an invasive procedure, but not surgical. Patients are sedated, but usually awake throughout.

The catheter is guided through the artery with the aid of a special x-ray machine. Contrast material (dye) is injected through the catheter and x-ray movies are created as the contrast material moves through the heart’s chambers, valves and major vessels.

The interventional cardiologists in the ‘cath lab’ then watch your beating heart up on the monitor, where they can spot any coronary arteries that are blocked or narrowed, and evaluate your heart function. If significant blockages are seen, further procedures like balloon angioplasty, stent implants or coronary artery bypass graft (CABG) – commonly known as bypass surgery – may be attempted to restore blood flow to the threatened heart muscle.

I’ve undergone two of these invasive cardiac procedures – the first an emergency catheterization and stent implant when I was hospitalized for a heart attack, the second 15 months later to investigate ongoing cardiac symptoms. And I can tell you that it is freakishly fascinating to lie on the cath lab table, sedated yet very awake, and watch your own beating heart on the overhead monitor.   Continue reading “Inside your heart – as captured by National Geographic”