ashurrutia
13-08-13, 02:45
Perhaps this thread doesn't belong here, but I feel a lot of us OCD sufferers will likely take this more to the heart(no pun intended:D).
Lately I've been through my face of more frequent reflux, likely due to either stopping taking curcumin, or something new on my diet/supplements. Now I'm kind of a veteran at this, so I decided to do the worst and google "reflux vs. heart disease". Now seeing things from a different point of view, I understand why some of us will end up in the ER for no reason, or make our health anxiety worse, etc. Notice these two articles were written by the same person, and in the medical terminology they refer to such cases as anecdotal. Nonetheless this exemplifies, that it is not only in our minds, but the internet does feed our fears.
Beware(read at your own risk):
http://voices.yahoo.com/can-impending-heart-attack-misdiagnosed-as-gerd-8811433.html?cat=70
http://voices.yahoo.com/chest-pain-imminent-heart-attack-misdiagnosed-7910940.html?cat=70
The story here is the elderly mother of the writer complaining of Chest Pain for a couple of weeks, and then vomiting one day. The writer takes her to the ER where the usual routine of Chest x-ray, troponin test(cardiac markers), and resting EKG is done, everything seems "normal" minus the EKG showing a "left bundle block" which renders it kind of useless. She is given the diagnosis of GERD and sent home. Two days later, she was taken again to the ER, where a troponin test showed elevated cardiac enzymes, and an Echocardiogram showed abnormalities in the heart, which prompted an angiogram, then long story short she went for a "quintuple bypass surgery".
Now the writer pretty much uses a series of misinformation, and anecdotal information to "scare" people, perhaps, her intentions were the best, but such writing could cause unnecessary stress specially to folks with health anxiety, and definitely translate into people going to the ER for no reason and costing the local economy.
First the writer refers to a doctor:
"Dr. Liu says, "Chest pain and pressure is an emergency symptom. It's the one thing people should relay to the triage nurse in the ER department to get moved to the front of the waiting room in a busy ER.
[...]
Dr. Liu explains, "I definitely think heartburn can mimic cardiac disease as well as the reverse. The message would be not to ignore symptoms of chest pressure, burning, indigestion, because either GERD or heart disease (http://voices.yahoo.com/topic/4291/heart_disease.html) is a serious matter. Heart disease can take one's life immediately, while GERD can take one's quality of life away, not to mention increase the risk of esophageal cancer."
Then she says:
"Don't pass this off as, "Oh, it's only indigestion." This can be a fatal mistake."
Now, yes, completely ignoring chest pain, if you have the risk factors for heart disease(i.e. Age, smoker, sedentary, family history, etc) it could be fatal. Now if you have had checks, like most of us, then it is just adding to the stress.
She then says:
"I took my mother to the ER where she had a chest X-ray (normal), EKG (atypical) and blood test (normal) -- none of which can detect severely blocked coronary arteries."
Now this is plainly ignorant, the idea that the combo of EKG,Cardiac Markers, and chest X-ray cannot detect CHD, let alone severe CHD is just plain bogus, a quick search in google scholar will reveal tons of entries about the sensitivity of troponin in the detection of CHD, and also resting EKG, which at is worst still yield a sensitivity of 50%, at is best 70%, nonetheless the more severe the CHD, the higher the sensitivity.
She then supports her position again using anecdotal evidence:
"My sister is a medical doctor. She flipped when I told her the ER doctor diagnosed my mother's chest pain and shortness of breath as GERD. "This happens all the time!" fumed my sister. "Chest pain is so often misdiagnosed as GERD and patients are sent home and then have a heart attack!""
She concludes giving the readers some "advice":
"Warning: If the troponin test, chest X-ray, EKG, blood pressure and heartbeat are normal and you've been diagnosed with GERD based on a questionnaire -- insist upon further tests to absolutely rule out significantly blocked arteries, even if it means having to be admitted.
[...]
If you have chest pain and the ER doctor diagnoses you with GERD, get a CT angiogram! A compelling study (http://www.associatedcontent.com/article/6242798/chest_pain_in_er_best_test_to_rule.html?cat=70) shows that a CT angiogram is an invaluable tool for screening for severe coronary artery disease in the ER. Don't just go home like my mother did and think that chest pain that awakens you at 5 am (as with my mother) can be explained by mere indigestion."
Now this is just unproductive. Take myself as an example, a healthy 25 year old admitted to the local ER back in September of 2012 complaining of stabbing chest pains, and rather very nervous. Troponin, CK-MB, chest X-ray, and EKG, blood pressure, etc are normal. I am discharged with a diagnosis of GERD, and chest pain nonspecific. If I had read this article, I would have pushed for a CT angiogram, which is not only costly, but also harmful, as it involves radiation, so getting an unnecessary test, is not just unproductive, but also harmful in the long run. I for other reasons(health anxiety) happened to have 4 more EKGs afterwards, all of which have been normal. Finally after almost a year, and 90% reduction on my health anxiety level, I'm still here, I haven't died of a heart attack, and it is very unlikely that I will have one in the next 10 years.
The point here is that, these two articles are neither scholarly, nor are they informative. A similar story would be one of a guy who walked below a set of stairs and it fell on him, killing him, then the writer advices everyone to avoid walking below stairs based upon that evidence. I encourage you guys to look up stuff in google, to get inform, but realize, that often times, anecdotal reports aren't useful, large double blind studies done by team of scientist would be a good start if you want to inform yourself about something.
Anyhow, I hope my little rambling was useful to all of you. If you have any questions, concerns, fire away.
PS: GERD doesn't increase esophageal cancer significantly(I've seen the research), it isn't any where near as bad as say smoking, or drinking alcohol, I have yet to see smokers quitting because they are afraid they'll get esophageal cancer.
Lately I've been through my face of more frequent reflux, likely due to either stopping taking curcumin, or something new on my diet/supplements. Now I'm kind of a veteran at this, so I decided to do the worst and google "reflux vs. heart disease". Now seeing things from a different point of view, I understand why some of us will end up in the ER for no reason, or make our health anxiety worse, etc. Notice these two articles were written by the same person, and in the medical terminology they refer to such cases as anecdotal. Nonetheless this exemplifies, that it is not only in our minds, but the internet does feed our fears.
Beware(read at your own risk):
http://voices.yahoo.com/can-impending-heart-attack-misdiagnosed-as-gerd-8811433.html?cat=70
http://voices.yahoo.com/chest-pain-imminent-heart-attack-misdiagnosed-7910940.html?cat=70
The story here is the elderly mother of the writer complaining of Chest Pain for a couple of weeks, and then vomiting one day. The writer takes her to the ER where the usual routine of Chest x-ray, troponin test(cardiac markers), and resting EKG is done, everything seems "normal" minus the EKG showing a "left bundle block" which renders it kind of useless. She is given the diagnosis of GERD and sent home. Two days later, she was taken again to the ER, where a troponin test showed elevated cardiac enzymes, and an Echocardiogram showed abnormalities in the heart, which prompted an angiogram, then long story short she went for a "quintuple bypass surgery".
Now the writer pretty much uses a series of misinformation, and anecdotal information to "scare" people, perhaps, her intentions were the best, but such writing could cause unnecessary stress specially to folks with health anxiety, and definitely translate into people going to the ER for no reason and costing the local economy.
First the writer refers to a doctor:
"Dr. Liu says, "Chest pain and pressure is an emergency symptom. It's the one thing people should relay to the triage nurse in the ER department to get moved to the front of the waiting room in a busy ER.
[...]
Dr. Liu explains, "I definitely think heartburn can mimic cardiac disease as well as the reverse. The message would be not to ignore symptoms of chest pressure, burning, indigestion, because either GERD or heart disease (http://voices.yahoo.com/topic/4291/heart_disease.html) is a serious matter. Heart disease can take one's life immediately, while GERD can take one's quality of life away, not to mention increase the risk of esophageal cancer."
Then she says:
"Don't pass this off as, "Oh, it's only indigestion." This can be a fatal mistake."
Now, yes, completely ignoring chest pain, if you have the risk factors for heart disease(i.e. Age, smoker, sedentary, family history, etc) it could be fatal. Now if you have had checks, like most of us, then it is just adding to the stress.
She then says:
"I took my mother to the ER where she had a chest X-ray (normal), EKG (atypical) and blood test (normal) -- none of which can detect severely blocked coronary arteries."
Now this is plainly ignorant, the idea that the combo of EKG,Cardiac Markers, and chest X-ray cannot detect CHD, let alone severe CHD is just plain bogus, a quick search in google scholar will reveal tons of entries about the sensitivity of troponin in the detection of CHD, and also resting EKG, which at is worst still yield a sensitivity of 50%, at is best 70%, nonetheless the more severe the CHD, the higher the sensitivity.
She then supports her position again using anecdotal evidence:
"My sister is a medical doctor. She flipped when I told her the ER doctor diagnosed my mother's chest pain and shortness of breath as GERD. "This happens all the time!" fumed my sister. "Chest pain is so often misdiagnosed as GERD and patients are sent home and then have a heart attack!""
She concludes giving the readers some "advice":
"Warning: If the troponin test, chest X-ray, EKG, blood pressure and heartbeat are normal and you've been diagnosed with GERD based on a questionnaire -- insist upon further tests to absolutely rule out significantly blocked arteries, even if it means having to be admitted.
[...]
If you have chest pain and the ER doctor diagnoses you with GERD, get a CT angiogram! A compelling study (http://www.associatedcontent.com/article/6242798/chest_pain_in_er_best_test_to_rule.html?cat=70) shows that a CT angiogram is an invaluable tool for screening for severe coronary artery disease in the ER. Don't just go home like my mother did and think that chest pain that awakens you at 5 am (as with my mother) can be explained by mere indigestion."
Now this is just unproductive. Take myself as an example, a healthy 25 year old admitted to the local ER back in September of 2012 complaining of stabbing chest pains, and rather very nervous. Troponin, CK-MB, chest X-ray, and EKG, blood pressure, etc are normal. I am discharged with a diagnosis of GERD, and chest pain nonspecific. If I had read this article, I would have pushed for a CT angiogram, which is not only costly, but also harmful, as it involves radiation, so getting an unnecessary test, is not just unproductive, but also harmful in the long run. I for other reasons(health anxiety) happened to have 4 more EKGs afterwards, all of which have been normal. Finally after almost a year, and 90% reduction on my health anxiety level, I'm still here, I haven't died of a heart attack, and it is very unlikely that I will have one in the next 10 years.
The point here is that, these two articles are neither scholarly, nor are they informative. A similar story would be one of a guy who walked below a set of stairs and it fell on him, killing him, then the writer advices everyone to avoid walking below stairs based upon that evidence. I encourage you guys to look up stuff in google, to get inform, but realize, that often times, anecdotal reports aren't useful, large double blind studies done by team of scientist would be a good start if you want to inform yourself about something.
Anyhow, I hope my little rambling was useful to all of you. If you have any questions, concerns, fire away.
PS: GERD doesn't increase esophageal cancer significantly(I've seen the research), it isn't any where near as bad as say smoking, or drinking alcohol, I have yet to see smokers quitting because they are afraid they'll get esophageal cancer.