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Left Hospital AMA
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Left Hospital AMA

43 year old female, pack a day smoker since I was 10 years old, high cholesterol for the past 10 years (uncontrolled), "weekend warrior" for yard work but otherwise sedentary with a very high stress job. I have had chest pain, light headedness, and jaw/neck/shoulder/arm pain off an on for several years, but my EKGs and heart sounds have always been normal, including during a physical I had two months ago. I do have severe GERD with Barrett's Esophagus.

Yesterday, while digging a flower bed, I suddenly became very tired. I went to sit down and drink some ice water - don't recall if I actually got a sip of water or not because my entire chest suddenly felt like it was on fire. Over the next 5 - 10 minutes the feeling intensified to the point where I really couldn't speak. Pain radiated up both sides of my neck (especially left side) and through my jaws. I have never experienced anything like this before, and the pain I've had in the past always happened at rest and never reached this intensity.

My husband and I rushed to the ER, but the symptoms had subsided by the time we got there. I was told my EKG had a slight abnormality and that because of that, plus my symptoms and my risk factors, they needed to admit me to the hospital to test for elevated cardiac enzymes and for a stress test/echo-cardiogram. I get severe claustrophobia, but managed to make it through the night. They gave me a nitroglycerin patch last night, and this morning they gave me a shot in the belly of some kind medication to prevent blood clots. Early this morning, a nurse told me my cardiac enzyme levels were normal. I spoke to the doctor and left the hospital against medical advice because I could no longer tolerate the claustrophobia, and because they shrugged it off when I told them I'd awakened with a feeling like a gorilla sitting on my chest. Unfortunately, I missed the opportunity to get the stress test done today because I left the hospital. I plan to call the Austin Heart Hospital to schedule a stress test, etc., for as soon as they can fit me in.

I keep telling myself this is nothing - anxiety over some kind of esophageal spasm or something, I'm hoping - but I am very concerned about the potential for vascular or heart problems. I have a very hard time communicating with doctors and would like to make sure I ask for the right tests and ask the right questions when I call for help tomorrow (today was a holiday and the doctor's offices were all closed).

Any advice?

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7 Comments Post a Comment
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159619_tn?1318997813
First off, it it were me I would be back on my way to the hospital, leaving was not a good idea, to me anyways. Your symptoms are classic for a heart attack, unfortunately they are also classic for an esophageal spasm as both affect the same nerve bundle,  have identical symptoms and both are relieved with nitro. Having said that, I would have stayed.

Since you did not, I would get whatever test they had recommended. You definitely need a stress test, preferably with nuclear profusion and an echo so they can check the blood flow to you heart muscle, get a more detailed EKG and check the structure of your heart. There is way too much to risk here and you need to see if it was your heart or GERD.

It's not too late to go back, just give them a call.

Good luck,

Jon
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460185_tn?1326081372
I had a heart attack last year and my advise, for what it's worth, is - go to the hospital.  A heart attack is far worse than claustrophbia.  Have the stress test - have every test you can and please DON'T WAIT.  Your GERT and heart issues are closely related; that's why so many women mistake angina or heart pain for GERD or acid reflux.  Please, please go back to the hospital and take advantage of the warning your body gave you.  I didn't know the pain I felt was a heart attack because it wasn't like you see on TV  and I even slept through it.  If some instinct hadn't made me get my daughter to call 911, I don't know if I'd be sitting here writing this.

Regarding asking questions - write them down so you can remember them (I forget when I'm anxious) and if the doctors don't/won't answer don't leave their office till  they do.   If they still won't answer, find another cardiologist.  It's YOUR body and you have the right to know what is going on.  Keep asking and sometimes it's good to take someone with you for moral support.

I wish you the best.



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237039_tn?1264261657
I am the "AMA" queen here in Texas.   What you are describing does sound like it could be cardiac in nature.  I get what I call a burning ache in my chest that radiates up to my cheek bones and down both arms.  At times there is a tingling in my upper back between my shoulder blades.  I would definitely go back and let them run the tests.  Take care and keep us posted.  Ally  
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187666_tn?1331176945
I'm here to put on the pressure too and I don't mean on your chest. You really should go back for further testing. Not next year or next month or the next time you're on the floor in pain. Go now. All that pain is a warning of something bad going on. Maybe you got lucky and it wasn't a heart attack this time. It could be angina caused from vasospasms or a partial blockage. But either one of those need to be managed.

Do you really want to live on the edge waiting for the next pain to hit?
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Avatar_f_tn
Just wanted to let you all know that I followed your advice, today. I went to the ER at the Heart Hospital (a different hospital) and explained the situation. They checked me out again and this time my EKG was normal - my cardiac enzymes are also still normal. The doc is having the hospital call me tomorrow to schedule a Cardiolite stress test. He said he is leaning heavily towards this not having been a cardiac event, but wants to get me tested further because of my risk factors, family history, and the symptoms I described.  So that's a relief!

For what it's worth - I was unable to get an appointment to see anyone, including my primary care physician, today, because it was the day after a holiday.

I appreciate the good advice, and thank you for responding.
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187666_tn?1331176945
Thank you for writing back and also for going in to be checked. We don't want you to be another statistic on the cardiac events graph. Take care.
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159619_tn?1318997813
Thanks for letting us know and GOOD FOR YOU! Now really, doesn't that feel better?

Keep us posted,

Jon
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