Father experiencing possible angina?

[Beth]

I am a concerned about my father who is 51 years old physician. He is currently on three different Rx for HTN which are successful in reducing his BP, and he also is 15-20lbs overweight. I know my dad tries to exercise routinely, but late nights at the hospital and being on call don't always allow for it.  He also developed A-fib a few years back, but it does not seem to bother him anymore.

Four wks ago, I overheard my father complaining to my mother(also a physician)about CP. He described it as a "crushing pressure" that intensified with deep breathing.  Additionally, he said that when he felt this precordial pressure, sometimes he would experience three or four acute surges of pain in synchrony with his heart beat. He also complained of lingering soreness in his left trapezial ridge and his left deltoid both which did not go away with when the chest pressure subsided.  My mother wanted to take him to her office and do an EKG and labs at that very moment, but my father said he would follow up on it.  (Personally, I know my father has yet to do anything about it!)
  
When I went to wake him up this morning(my mother was on call last night), my father was laying awake in bed with slight diaphoresis and apparent SOB.  I asked if everything was OK and attempted to take his pulse, but he quickly shook my hand off his wrist. (He was obviously tacycardiac because chest was rapidly palpitating.) I then ask him to humor me and let me take his BP, but he quickly retorted with a "no."  Honestly, just by the grimace on my father's face, you could tell he was in bad shape and that he was a lot of pain.  

I know my father is an intelligent man, but he tends to overlook his own health. The level of stress in his life is fairly high, as it is for most physicians.  Additionally, there is a FH of CHD and SCD. My paternal grandfather had his first MI at 54 and my grandmother at 62. Both had preexisting HTN and my grandfather also had a-fib. I find all of this very significant.

When I confronted him later in this morning, he told me that I am not a doctor yet, and didn't know what I was talking about.  He completely denied that the pain was cardiac related because of its frequency and because the manifestation of pain was not characteristic of AMI or even angina.  So, is my father right?   Do physicians tend to deny obvious warning signs of potential health problems because they deal with patients who complain of the similar symptoms on a daily basis? If not angina/AMI, what could this be?

I love my father dearly and want him to be around for a long time. As a daughter, what should I do?  I think this is pretty serious and he continues to disregard it. Thanks.

[CCF CARDIO MD - DLB]

You are definitely right and he is definitely wrong. I cannot say for sure whether he has heart disease, but given his family history and recent symptoms, he absolutely needs a cardiac evaluation, the sooner the better. If this were a patient, I am sure he would recommend an urgent evaluation - why does he treat himself differently. Doctors often try to diagnose themselves (a mistake) or have a colleague or family member evaluate them informally (also a mistake) - he needs a formal cardiac evaluation now. You could try telling your mother again and you could try telling his partner(s), though this may make him angry. Good luck.

[kristin]

All I can say is that my father-in-law died of MI after several days of chest pressure symptoms that he ignored (e.g. woke up after dreaming that something was sitting on his chest!)...

He wasn't a doctor, but sounds a lot like your dad, convinced nothing could be wrong with him. Good luck. I hope he'll listen to you.

[emma]

as his daughter, you are probably in the best position to get your father to the dr. - in an even better position than your mother. if you have brothers and sisters that's good too - you can all beg, plead, and urge him together.  you could even go so far as to make an appointment for him and then tell him you expect him to take you out to lunch after - try everything you can!  good luck!!!

[Cindy]

I share your concern about your father.  I also have a father who denies that any symptoms that he is having is related to his heart.  It sounds very suspcious to me, and your dad needs to get a complete workup.  He is still human even though he has the knowledge he can still be very scared.  Sometimes the fear of all the testing isn't the tests themselves but rather what information they may find.  I am a cardiac nurse and agree with your assessment he needs to be evaluated.  These are warning signs and your dad realizes that but is scared.  Sometimes having the knowledge isn't always the easiest thing.  I am sure that all kinds of thoughts are racing through his mind.  My thoughts are with you and I too am experiencing similar frustrations with my own dad.  It is hard when you love them so much and want to help.  You are in my prayers.