Can you make the diagnosis?

Susan is having a bad day at work.  She’s been in stressful meetings all morning, and she has a report to finish by the end of the day.

After lunch, she starts having heartburn.  She takes two antacid tablets, but it doesn’t seem to get any better.

Susan has had heartburn before, and has Prilosec at home she sometimes takes.  She also has a medical history of high blood pressure, and at her last doctors appointment they told her that her cholesterol was too high.

By about 4 pm, the heartburn is really bad, and even goes into her neck and jaw.

What should Susan do?

  1.  Take more antacids and get her report done for work.
  2. Wait until she gets home and take her Prilosec.
  3. Get an EKG immediately, she may be having a heart attack.
  4. Schedule an appointment with her doctor in two weeks for her severe heartburn.


If you chose 3, you are right!

Heart attacks can mimic different medical conditions.  Heart pain, “angina”, usually causes pain in the center of the chest (substernal) or to the left side.  Many patients with heart conditions do not describe it as “pain”, but instead describe it many different ways such as pressure, crushing, or even describe it as feeling like heartburn.  The pain can radiate to the arms, more often on the left, and can radiate to the back, neck, and jaw.    Angina can be associated with sweating, nausea, shortness of breath, and irregular heart beat sensation (palpitations).

Patients who are higher risk of heart attacks include those with high blood pressure (hypertension), high cholesterol or triglyceride levels, smokers, those with a family history of heart problems, diabetes, obesity, and smokers.    Men have higher risk of heart attacks then women, but women have heart attacks too, and cardiovascular disease is the number one killer of both women and men.

When a patient has new or persistent symptoms, they should get an ekg and may need additional testing as well, such as blood work or treadmill testing.  Early diagnosis and treatment can prevent permanent heart damage.

chest pain

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: