Thursday, March 15, 2007

Wait Until Monday to have that Heart Attack

So it's best not to have a heart attack on the weekend, lest you be unable to get to a cath lab within 90 minutes (h/t: Ann Althouse, guestblogging at Instapundit). I am glad that some hospitals like the one that is quoted in the article are concerned about treating patients quickly, but they still seem to miss the point that just as important as getting people quickly into treatment is recognizing that they are having a heart attack in the first place:

The largest ones are equipped. Massachusetts General Hospital has one of Boston's busiest emergency rooms. On one afternoon this week, all the chairs were filled with patients waiting to be seen.

But cardiologist Jim Januzzi says there is no wait for a patient who comes in with chest pain. Doctors and nurses leap into action to see whether that patient is having a heart attack.

But guess what? Up to one in four heart attacks, especially in women, (but they also happen in men) are silent heart attacks that cause damage and even death, but the symptoms are atypical--no chest pain involved--and unbelievably, many doctors and hospital staff do not look for heart problems if there is no chest pain present. There are symptoms of a silent heart attack; these include, shortness of breath, heartburn that worsens with exertion, nausea, fainting, profuse sweating, and feelings of overwhelming doom.

So, a few things to remember to protect your heart health--know which hospitals in your area have a cath lab open on the weekends or have your heart attack during the week and remember that chest pain is not the only indicator of a heart attack. I never had chest pain with my heart attack and this baffled doctors for ages. Take your health into your own hands and if you are having symptoms other than chest pain and feel that it might be heart-related, speak up and demand that the docs treat the symptoms seriously and immediately. Waiting too late like I did could end in disability, heart damage or death.


Blogger Sirena said...

Heard that on NPR this morning, I bet a lot of the symptoms are misdiagnosed as panic disorder especially with women
--since we get "the hysterics" and all.
Panic disorder is popular right now and a case for the psycholization (I just made that up in compare to medicalicalization) or should it be psychologicalization?) of a medical condition being misdiagnosed/treated as psychological.
Too bad.

3:09 PM, March 15, 2007  
Blogger Helen said...


Yes, it is true that much of the "impending doom" feeling of a heart attack looks like panic disorder and is treated that way, at least it was seven years ago when I had my heart attack. I have heard from others who have had heart attacks more recently that doctors are bettter at recognizing the symptoms now than they were in the past.

3:19 PM, March 15, 2007  
Anonymous Anonymous said...

Sirena and Helen,

Would one difference between a panic attack and this symptom you describe be that panic attacks would be chronic, and this feeling of impending doom would be a one-off? Then the issue is for the docotor to listen to and respect what the patient is saying - that can be asking a lot - but they should be different enough to distinguish, shouldn't they?

6:15 PM, March 15, 2007  
Blogger Sirena said...

For a long time, physicians considered heart disease to afflict mostly males and the typical signs of heart attacks were thought to be those as exhibited primarily in men.
Currently, there is an increasing awareness of the manifestations of heart disease in women. Women's symptoms look atypical compared to the "typical" heart disease symptoms found in men. As we are recognizing heart disease in women we are also finding that men have similar "atypical" symptoms as women.

In other words, the increasing recognition of heart disease in women is contributing to a broader understanding of the symptoms in everyone and bringing light to treatment problems such as hospitals that lack cath labs on weekends.

My boyfriend's brother was at a healthy check up doing an endurance test on a bike --told the physician he felt sick to his stomach next thing you know he's having a quadruple bypass. --He showed no signs of "typical" heart attack such as chest pain.

And Jim I'm not a physician but I think if I had a female patient and she talked of symptoms that sounded like a panic disorder I would first screen her for heart problems.

Physicians are beginning to screen women for heart disease and women are becoming aware that it is a disease that affects them too.

9:09 PM, March 15, 2007  
Blogger Helen said...


I believe I read somewhere that the sense of impending doom and "not feeling right" could occur at least a month before the heart attack. I think the key is that if you are not typically prone to anxiety or panic or if your anxiety exacerbates from your norm and you suddenly get more symptoms, get a check-up.

It is hard to distinguish panic disorder from a heart condition--one reason is that cardiac arrythmias from a heart attack or blockage can cause panic symptoms that mimic an anxiety disorder. My symptoms, however, came on very strongly and were so unbelievably mind altering that I knew something was wrong, even if the doctors didn't. I hate to sound new agey, but listen to your body and if you feel symptoms that you have not felt before, get them checked out and be insistent that they check your heart. An EKG takes five minutes.

7:47 AM, March 16, 2007  
Anonymous Anonymous said...

I'm glad Helen made it. Listen to her.

I have a problem in that the feeling of overwhelming doom is pretty much normal for me. If I suddenly start feeling like everything's going to be ok, should I go to the emergency room?

12:46 PM, March 16, 2007  
Blogger Helen said...


I guess if the feeling of impending doom is normal, then you are safe. But it has to be nerve racking. Why live with such a bad feeling? Or maybe it is comforting to you?

1:42 PM, March 16, 2007  
Anonymous Anonymous said...

Well, working for the Government probably has a lot to do with it...

4:34 PM, March 16, 2007  
Blogger Unknown said...

Well, better late than never-

I think it's important to mention the role of aspirin in heart health-

Think about taking an aspirin (usually suggested- an adult low dosage- use to be baby aspirin- not a good idea to do that anymore)daily (ask your doc)-

And if you think you might be susceptible to a heart attack, carry non enteric-coated aspirin (325 mg) with you and chew one if you ever have symptoms of a heart attack (is it appropriate to wish that if you're going to have a heart attack, that you get the easily recognizable chest pain symptom?)-

I am not a physician; I am not a nurse-

I just wanted to bring this up as something for all to consider, and if someone has information to the contrary, well, hey, go for it!-

4:41 PM, March 17, 2007  

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