Congestive Heart Failure Symptoms

[Debie-D]

  Please help me.  There is no emergency, I just need to understand a few things.
  My mother, Sharon (who lived in Iowa) started having all kinds of things go wrong with her body.
  February 1998, she had extremely dry skin, white and peeling and she complained
  that her nails were extremely brittle and wouldn't grow.  I suggested vitamin
  E, B12, wheat germ and seeing a doctor.  In July, she developed sores all
  over her arms and legs that wouldn't heal and she complained of pain after
  she ate, she said that the doctor told her that it was acid-reflux.  She
  said that she couldn't sleep at night and would rest better sitting in her
  easy chair.  I thought that she was just really missing my father who died
  of a brain tumor March of '89.  In September, she visited my family in CA
  and really talked about not wanting to eat because it hurt too much, her
  skin and sores wouldn't heal and her brain seemed out of control, she felt
  out of control of her thoughts sometimes, she forgot a lot.  Again, I asked
  about going to a doctor, though neither of us have much faith.  My father
  was misdiagnosed with a migrain and told that nothing was wrong until they
  finally ran an MRI and found a brain tumor the size of a grapefruit.  The
  attempt to do a byopsy destroyed his brochia and took away the man inside
  until he died 6 months later an invilaid.  So I didn't push the doctor issue
  much.  In November we visited her in IA and the pain had gotten so bad she
  really didn't eat or sleep much.  Finally November 10th she went to a clinic,
  she was shuffled dr. to dr. and finally one of them ran some tests.  He was
  pretty sure that she had a heart problem and set her up with an angiogram.
  Then he cancelled the tests and decided that she had a thyroid dissorder.
  He did not run any heart tests and did not consult a thyroid specialist.
  This dr. called a thyroid dr. and had him prescribe medication for my mother
  to be taken at doses gradually increasing the amount, set her up with an
  appointment to see the thyroid specialist after her vacation then gave her
  his blessing for her trip across country driving to Florida to see her
  mother.  I spoke to her December 3rd in Hot Spring, AR enroute to Florida.
  She told me about seeing a dr., of course we were both relieved that it wasn't
  her heart.  She arrived in Florida on Tuesday, Wednesday night my grandmother
  found her sitting up all night because the pain was so bad she couldn't
  sleep.  She didn't think anything was an emergency because she had seen
  a dr. who said that her heart was fine, her thyroid was messed up and the
  pills would straighten it out.  She thought that the additional pain was
  a side effect of the medication.  She was wrong.  3:00 Thursday, my uncle
  saw her and said you need to call the thyroid specialist, the nurse at the
  dr's. office told her to get to ER.  It was too late, she had had a heart attack
  2 days earlier, drove to FL, and by the time someone who knew anything could
  see her, it was too late.
  My questions are, are the skin, nail, sores, pain and heart attack all related?
  Did the thyroid medication overwork an already overworked heart?  If I
  had called 911 after talking to her in AR, would she have been saved, and
  if so would she be rather healthy, or an invilaid?
  I know that this is long, I have no one to talk to.  I need answers.  
  Thank you.

[CCF CARDIO MD APS]

Dear Debbie,
It is really difficult to comment on your mother's health when you speak of no particular medical diagnosis
other than a heart attack, besides, hind site is 20/20 and I will not make medical judgements based on
events that already occured. Basically and unfortunately it is a fairly common occurence for people to think
they just have the flu, or a cold, or indigestion when really they are having a heart attack.  It sounds like you
and your family members really did all that you could to get your mom to seek proper care, unfortunately the timing
was wrong.  Although your mother's care sounds somewhat disjointed (this may be because you are recounting an emotional story)
NO physician can say with 100% certainty when you leave his/her office that you will not be in any danger; the premise that we all
assume as a patient leaves our offices is that should anything change (new symptoms develop, or old ones are not getting better or are gettting
worse with the prescribed treatment) that patient will seek care in an emergency room if not call the office of the physician in a prompt manner.
Again, it sounds as if your mother had symptoms of a threatening heart attack that are not typical which often leads to a late diagnosed heart attack.
The most important thing for you and the family to concentrate on now is the current and future care or management of your mother's health. A general internist
who knows about thyroid and heart (with the help of a cardiologist) needs to care for your mother.  
I hope that this information has been helpful, please feel free to write back with any further questions.
Information provided in the heart forum is intended for general medical informational purposes only, actual diagnosis and treatment can only be made by your physician(s).