DEAR DR. ROACH: I recently went to my family doctor, complaining of left arm pain and heart burnlike pain in my throat area. He said that he could admit me to the hospital for two days of testing or that it could be a pinched nerve in my neck. It was my choice not to go to the hospital, so he recommended meloxicam for a possible pinched nerve. As it turns out, my symptoms later became so uncomfortable that I decided to go to the ER three days after seeing my doctor. It was a serious blockage of a main artery to my heart, and emergency surgery was performed to put a stent in. I am lucky to have made it in time.
I realize that it was my decision to not be admitted — I guess I was in denial. I never thought to ask him if he could have given me an electrocardiogram there in his office, and some people, including my intensive-care nurse, asked why he didn’t. Because he didn’t offer to test me in his office, I am considering changing doctors. I like him and he has always given me good care in the past, so I’m not sure what to do. I feel that had he done the ECG that day, my problem could have been diagnosed much sooner and possibly prevented my heart attack.
Why wouldn’t he have checked my heart function right there with the electrocardiogram? He did check my blood pressure and listen to my heart, but those seemed to be normal. Can you give me your opinion on this? I am a 64-year-old male. — F.M.
ANSWER: Without being there, I can’t give an opinion on whether your doctor should have insisted on your being admitted to the hospital, but I am printing your letter to once again emphasize that heart disease, even serious blockages, can have minimal or no symptoms. It sounds like your doctor did suspect heart disease, and I bet he now regrets not insisting that you be admitted. It’s a judgment call, and you have to consider not only the symptoms, but also the risk factors. Just being a 64-year-old man is a risk factor; if you had other risks, such as elevated blood pressure, cholesterol, a history of smoking or a family history of heart disease, that would make heart disease more likely.
The electrocardiogram is not a perfect test, and although it might have been abnormal at the time, it also is possible that it could have been perfectly normal. In hindsight, I wonder if your knowing your EKG was normal would have kept you from going to the emergency room when you did.
To me, this isn’t so egregious that I would suggest you find a different doctor, but only you can decide whether you still have confidence in him.
READERS: Heart disease remains the No. 1 killer. The booklet on clogged heart arteries explains why they happen and what can be done to prevent clogging. Readers can obtain a copy by writing: Dr. Roach — No. 101W, 628 Virginia Drive Orlando, FL 32803. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Please allow four weeks for delivery.