The “handlebar gripping” cardiac symptom

by Carolyn Thomas       @HeartSisters

When the Emergency Department physician misdiagnosed my “widow maker” heart attack as acid reflux, I actually felt relieved at first.  I’d much rather have indigestion than heart disease, thank you very much. His confident misdiagnosis meant I was temporarily willing to ignore the obvious cardiac symptoms that had propelled me to Emergency that morning: central chest pain, nausea, sweating and pain down my left arm.

Even I knew that arm pain is NOT a symptom of acid reflux, yet somehow that first plausible answer seemed preferable to the far more serious real answer I would receive much later.      .      . Continue reading “The “handlebar gripping” cardiac symptom”

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”

Dear Carolyn: “Did I have a ‘real’ heart attack?”

by Carolyn Thomas    @HeartSisters

As part of my occasional Dear Carolyn series featuring my readers’ unique narratives about how they became heart patients, I offer today a medical mystery from an Oregon reader. After dueling physicians differed in their opinions of her diagnosis, Lynn Bay now wonders if she actually did have a “real” heart attack, as one of them had diagnosed. Her story may seem familiar to you if you’ve ever had your medical experience dismissed or minimized. Here’s Lynn’s story, with her permission: Continue reading “Dear Carolyn: “Did I have a ‘real’ heart attack?””

Excuse me while I bang my head against this wall…

by Carolyn Thomas      @HeartSisters
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Last week, the disturbing results of a study on women and heart disease were released, attracting media headlines like Women and Heart Disease: New Data Reaffirms Lack of Awareness By Women and Physicians. I had to go have a wee lie-down after I read this paper in the Journal of the American College of Cardiology.(1)

The study’s lead author, cardiologist Dr. Noel Bairey Merz, of Cedars Sinai Heart Institute in Los Angeles, announced that “increasing awareness of cardiovascular disease in women has stalled with no major progress in almost 10 years”, and (far more intensely disturbing, in my opinion): “Little progress has been made in the last decade in increasing physician awareness or use of evidence-based guidelines to care for female heart patients.”

No wonder I had to lie down. But taking to one’s bed in response to yet another discouraging study about cardiology’s gender gap is no longer enough. Perhaps it’s time for female heart patients like me to simply throw our collective hands in the air while banging our heads against the nearest wall. Continue reading “Excuse me while I bang my head against this wall…”

Misdiagnosis: the perils of “unwarranted certainty”

by Carolyn Thomas    @HeartSisters

Until being misdiagnosed with indigestion in mid-heart attack, I generally trusted that all people with the letters M.D. after their names knew what they were talking about when diagnosing serious medical problems. That was long before I tracked down a study(1) reported in the New England Journal of Medicine that women under the age of 55 who are experiencing a heart attack are seven times more likely to be misdiagnosed and sent home from the E.R. compared to their male counterparts presenting with identical symptoms.

And that’s why I now find Dr. Jerome Groopman’s landmark book, How Doctors Think, so illuminating.  It should be required reading for all med school students.  Continue reading “Misdiagnosis: the perils of “unwarranted certainty””