Christian Medical Blog
Dorothy had reached her wit’s end. She had visited the emergency room of local hospitals at least three times over as many months, but still her pain continued. No answers.
As a new grandmother Dorothy didn’t have time to give so much attention to herself. She had reached the point where an explanation had more immediate value to her than a cure. Before she gave up she thought she would try once more.
Dorothy sat in the room quietly as I walked in and sat beside her. “What brings you here today?” I asked as I had done about fifty times already that day.
“I don’t know what to do, Doc.” She admitted.
“What do you mean?”
“Well, I have this pain. It’s in my chest. It’s been going on for several months and it just bothers me. Something is not right.”
I probably sighed a little bit, but she had peaked my interest with the words “chest” and “pain.” It was obvious she was not having a heart attack at the moment.
“Go on,” I said.
Taking a breath, she continued. “Everybody says it’s indigestion.”
“Why do they say that?”
“I don’t know. That’s they way I describe it to them. And, that’s the way it feels. I have burning right here.” She said pointing to the middle part of her chest. “But none of the indigestion meds I’ve taken have helped...and I think I’ve tried them all.”
This particular day I was exhausted. I was working a free after-hours clinic, and I had already had a full day at the clinic, nursing home, and hospital. I was almost inclined to agree with all the other docs she had seen, but something urged me to go a little deeper. “So what seems to make your pain worse? When was the last time you had it?”
“Doc, it happens almost everyday.”
“What are you doing when the pain happens? I asked.
“It’s hard to tell. Seems to happen when I walk and after I eat.”
“Like walking to the mailbox?”
“Yeah, my mailbox is a little walk from the house. I have indigestion almost everytime I go get the mail.”
“Wow.” I said to myself as I realized the problem. Dorothy was experiencing classic signs of heart disease. The indigestion she was describing wasn’t indigestion. That “not right” feeling was really “angina” in doctor-talk.
Knowing what was wrong had suddenly become the easy part of taking care of Dorothy. I remembered this was a free clinic and none of the patients there had any insurance. Having heart disease in America (or any country) is not a cheap problem to have.
Thinking about her options, I couldn’t come up with any resource that would make the finances work any easier. I looked Dorothy in the eyes and told her she was having a heart problem and needed further testing that only a heart doctor could do. I gave her several names of cardiologists and told her to make an appointment as soon as she could. As for the cost, I told her it would probably be expensive but it was extremely important.
As she left the clinic that night, I looked at her again and reiterated my point with a look from my eyes to hers. She nodded, smiled, and thanked me for my time.
Driving home, I reflected on her case some more. I was the fourth guy to see her, and I was almost the fourth guy to agree with her that she was having bad indigestion. Who knows what she told the other doctors. It is very common for patients to change their stories over time. This doesn't happen not because they are trying to be difficult, but because the longer people live with their symptoms the better they are at explaining them to the doctor.
I went on to think about God’s Grace and how I knew it was He that urged me to dig deeper. He was the one that gave me the wisdom at that moment in the day - when I was tired and ready to go home - to recognize her symptoms.
I also thought about how many other patients I have taken care of in the past who had the same kind of heart pains as Dorothy but were interpreted as something else by the patient.
Dorothy came back to the clinic a couple of months later, but not as a patient. She was standing at the window and asked to see me. I’ll be honest. I didn’t remember who she was until she told her story. I often forget names and faces, but I hardly ever forget a story.
Dorothy had followed my instructions. She found a heart doctor that would take payments on everything - clinic, labs, tests, etc. He agreed with what I had told her and did a heart catheterization which revealed a 99% blockage that he corrected easily with a stent.
She just wanted to say thank you. Dorothy and I talked for a little bit, and I went on to see the next patient.
“What brings you here today?” I asked for the fiftieth time.
Dorothy’s story has prompted me to write a list of Commonly Missed Heart Attack Symptoms. Check it out now and share it with anyone you think that might have unknown heart problems!
Just over 700,000 people have heart attacks every year. But when you ask people for a list of heart attack symptoms, rarely do they reply with more than the traditional answers. The most classic answers fall in line with your run-of-the-mill “television” heart attack.
Typical Heart Attack
But not every heart attack is like this! I have seen and taken care of so many people who waited (or almost) waited too late to come in to see me. They all had one thing in common. They didn’t think they were having a heart attack!
Why is that? Well, some of them were clearly in denial. They didn’t want to have a heart attack, so they decided they weren’t...even though they were. The other reason is that their symptoms were not typical.
Dorothy’s story is a good example. She thought she was having indigestion, but she was really having angina (heart pain). I hope you check it out, especially if you’re having indigestion!
To help you and others avoid waiting too late, I’ve collected a list of heart attack symptoms that you shouldn’t ignore.
Right-Sided Chest Pain
That’s RIGHT. Heart pain can show up as right-sided chest pain that radiates down the right arm. This presentation is quite common in women and diabetics for reasons not clearly understood. Ironically, the patient that comes to mind is a 60 year old farmer. He really played his symptoms down quite well. I’m not even sure he was the one that brought up his chest pain. He had exertional right-sided chest pain. That was his only symptom! At any rate he fought me tooth and nail on getting a stress test.The next week he was in the catheterization lab and multiple blockages were found.
Heart pain is not always crushing. Sometimes it is burning, and the burning feeling is what confuses people. Sometimes it confuses doctors too. It was not unheard of in the olden days for a doctor to list the cause of death for a loved one as “acute indigestion.” Especially worrisome is the indigestion that is exertional. “Everytime I do so-and-so I get indigestion.” Unless your “so-and-so” is eating spicy food, then I think you should get checked out. It may be nothing, but it may be something!
A patient of mine almost talked me out of an EKG once. She was only in my office because her daughter made her come. Her pain was right-sided and it happened just after she moved some furniture. She was convinced that she had pulled a muscle. After all, she had a normal stress test a few months before! That’s a topic for another day but don’t place too much emphasis on a single test. The stress test was falsely-negative. She had experienced a heart attack because of the exertion caused by moving the furniture. After I transferred her to her heart doctor in a bigger city, she had another heart attack later that night. The next day she underwent a bypass and is now doing much better!
Most people don’t think about abdominal pain as a possible heart problem, because it usually isn’t. However, if you have belly pain (especially upper belly pain) and all the routine tests are normal then maybe you should bring up the possibility of a heart problem to your doctor. If you have risk factors for heart problems (and your story is compelling) then you may benefit from heart testing.
Shortness of Breath
When you have a heart attack, your heart function usually decreases some. When your heart doesn’t work correctly, the blood doesn’t move through your lungs as well as it should. This causes shortness of breath. One of my patients was convinced that he was suffering from bronchitis because he had been very short of breath for a few days. When I examined him it was clear that more was going on than met the eye. He was an older gentleman, a fine man, and I had to do some fancy talking just to convince him that he needed to be in the hospital. Further testing confirmed that just prior to the onset of his shortness of breath he had experienced a heart attack. The heart attack caused severe heart failure by the time he came to see me in clinic.
Nausea and Vomiting
Nausea and vomiting are usually complementing symptoms of heart pain. This means that most of the time if your nausea and vomiting is due to heart pain then you will likely have at least one other symptom. So if you have some of the typical or atypical symptoms above as well as nausea and vomiting, then you need to take it more seriously.
Why are these symptoms so important?
Because I don’t want you to be one of the ones who waits too late. I want you to get regular exams by your doctor and have a good relationship with him or her. Anytime you are worried about your heart you should go get checked out. Do not explain away your symptoms, especially when they happen with exertion and when they happen frequently. Often times these “little” pains are your only hints at a deeper and more serious problem.
Prudence may be your only chance to get that deeper problem fixed before you have a heart attack!
DISCLAIMER: This blog is for fun only and none of the information in the posts or links are meant in anyway to constitute medical advice from anyone or for anyone. No material or interactions that occur on this website are meant to establish or continue a doctor-patient relationship under any circumstances. Everyone is different and there is never, ever a single answer that is always the same for everyone. If you need medical advice for a problem you have, go see your doctor and talk it over! If you are experiencing an emergency, seek emergency care as soon as possible.
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