Christine Junge

Doctors can confuse heartburn and heart disease, even in themselves

Most people are pretty good judges of what’s going on with their own bodies. But telling a heart attack from other causes of chest pain is tough stuff—even, it turns out, for highly trained doctors. That’s why I thought this personal story, written by a Harvard doctor who has heart disease, would make an interesting read. It’s an excerpt—the full version can be found in Heart Disease: A guide to preventing and treating coronary artery disease, an updated Special Health Report from Harvard Medical School.

Early one spring, I noticed a burning sensation high in my abdomen whenever I walked up a hill or worked out on the treadmill. I felt perfectly healthy otherwise. I had lots of energy and could do high-level exercise on the treadmill—once the burning sensation went away—without becoming short of breath. I thought it was just heartburn, so I started taking powerful acid-suppressing pills. They didn’t help.

Sometimes when I would feel the burning in my chest, I would remember an old saying to the effect that “A doctor who takes care of himself has a fool for a patient.” Still, I hesitated; I didn’t want to waste the time of a cardiologist if all I had was heartburn.

But one morning as I walked across the street from the garage to my office in the hospital, the burning sensation returned with a vengeance. When I got to the front door of the hospital, I was completely out of breath and couldn’t take another step. At that moment, the game was up: I knew I had heart disease, and that it was becoming worse.

I called my doctor. He ordered an exercise stress test that day. It was abnormal. The next day I had a cardiac catheterization. As I lay on the table, I watched the face of the cardiologist (a colleague of mine) as he performed the test. I saw him nod several times, and clench his jaw. Then he turned the video screen around so that I could see it, too. There, clear as day, was an ugly picture. Three different coronary arteries had blockages, and one showed an unstable, vulnerable plaque: a blood clot was forming at one blockage, threatening to shut down blood flow in the artery and cause a heart attack. I had seen such pictures many times before, but this time it was a picture of me.

The next day I underwent coronary artery bypass surgery. I was in superb hands, at a top hospital, and experienced no complications. Most important, although the vessels that supplied the heart with blood were diseased, we had caught the problem before a heart attack had injured my heart. My heart still pumps today as strongly as it did when I was 20.

Heart Disease covers everything you need to know about coronary artery disease, the manifestation of cholesterol-clogged arteries: what causes it, how to calculate your risk of having a heart attack, treating heart disease, the warning signs of a heart attack, and more. You can read the free online excerpt describing cardiac rehabilitation, which is about the best thing someone with heart disease can do for himself or herself. The report is available at http://www.health.harvard.edu/HH.

Related Information: Healthy Eating for a Healthy Heart

Comments:

  1. Tracy Adriana

    I’ve experienced symptoms of heartburn before, but didn’t realize that it could be so serious. This article was a real eye opener for me.

    To those of you out there who think you may suffer from heartburn, please do check up and see if you are suffering from any of the common symptoms of heartburn and consult a medical professional early if you do.

  2. Brian

    Thanks for important info for patients and doctors. One of the factors in heart disease is that they suffer from hyperventilation, and this also exacerbates problems with stomach acidity and work of GI valves.

  3. Richard Heart

    I get scared straight to the vegetable isle and gym reading these heart health articles!

  4. Carolyn Thomas

    I think it’s fantastic that this patient received such good care in such a timely fashion. Being “able to catch the problem before a heart attack injures the heart muscle” can make all the difference.

    It likely also makes a big difference if you happen to be:
    1. a Harvard doctor with instant access to colleagues offering world-class care
    2. financially comfortable so you have the means to pay for whatever needs doing, and
    3. a male

    Here’s what can happen to those who don’t make it into that Top 3 list: research on cardiac misdiagnoses reported in the New England Journal of Medicine looked at more than 10,000 patients (48% women) who went to their hospital Emergency Departments with chest pain or other heart attack symptoms. Women younger than 55 were SEVEN TIMES more likely to be misdiagnosed than men of the same age. The consequences of this were enormous: being sent away from the hospital doubled their chances of dying.

    And if a Harvard doctor is confused about the difference between heartburn and cardiac event, try being a woman in mid-heart attack. The AHA has a brilliant 30-minute film called “Just A Little Heart Attack” meant to convince women to call 911 immediately for cardiac symptoms: http://myheartsisters.org/2011/09/26/elizabeth-banks-heart-film/

  5. PetFlow

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