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A Heart Beats the Odds

June 03, 2020 by Cara Obradovitz

Heart disease remains the leading cause of mortality in the U.S. according to the Centers for Disease Control, with one in four deaths being the result of cardiovascular disease. The annual economic impact of heart disease is estimated to be $219 billion including the costs of health care services, medication and lost productivity.

The importance of maintaining your heart health can’t be overemphasized. Staying active, eating right, controlling blood pressure, not smoking and maintaining a healthy weight significantly reduce your cardiac risks. Regular checkups with your physician can help you catch signs of chronic heart disease early and allow you to make lifestyle changes that can actually reverse disease progression.

But sometimes the doctor gives you news that can make your heart skip a beat. Take the example of one woman who, on a recent Friday afternoon, was told her routine electrocardiogram (EKG) indicated a serious heart attack was occurring or was imminent. However, this patient was not showing any of the common signs and claimed to be feeling fine. She had no chest pain commonly associated with a heart attack.

It’s critical to note here, that women often exhibit different symptoms than men when suffering a heart attack. In fact, it can be difficult for women to associate their outward symptoms with a heart attack. Women more frequently will experience shortness of breath without chest pain, arm discomfort, nausea and jaw or back pain. But this woman didn’t have any of those symptoms either.

The physician sent her immediately to the hospital emergency room for further evaluation. A repeat EKG at the hospital showed the same shocking indications of an impending heart attack. The woman was admitted and scheduled for a cardiac catheterization as soon as it could be arranged. She was put on powerful blood thinners and received other tests over the weekend. Her blood tests for the enzymes indicating heart injury remained low, so the catheterization would not be done until the following Monday. Once the cardiologist performed the procedure, he determined the woman had completely clear coronary arteries and a strong, healthy heart beating normally.

So, what happened here, that a woman would need to stay three nights in a hospital and undergo an invasive procedure just to find out she had a perfectly healthy heart? It turns out that EKGs frequently identify problems that don’t really exist, results known as “false positives.” Clinical studies have shown that EKGs actually indicate far more false positives than “false negatives” (where the test fails to identify a real problem). This is because people are unique on the inside as well as the outside! The heart may be in a slightly different location or angle than average, or the EKG leads are placed in a way that affects the readings.

In this situation, because the second EKG at the hospital showed the same concerns as the one in the physician’s office, there was less likelihood of a false positive. While the hospitalization, blood thinners and the catheterization did expose this patient to medical risks, ultimately it was determined that the risk she had for heart attack was greater. Despite the inconvenience and stress of the ordeal, when the catheterization confirmed she had a strong, healthy heart, there truly was a cause for celebration.

When an EKG shows something that doesn’t look right, it may not mean it’s as serious as it looks. But it does mean it’s time to look further. Talk with your doctor about the next step to take and understand the risks involved. For one woman, the beat goes on to share precious time with her loved ones.

References

https://www.texasheart.org/heart-health/heart-information-center/frequently-asked-patient-questions/i-dont-think-i-had-a-heart-attack-but-my-ekg-suggests-it-please-explain-the-result/

https://www.sciencedaily.com/releases/2009/11/091116103435.htm

https://www.dicardiology.com/article/technical-factors-involved-false-positive-ecg-stemi-diagnoses

 

 

About Cara Obradovitz, B.S., M.P.H
Cara has gained a broad array of experience from her nearly 11 years of involvement in the health and wellness industry, working with small, medium, and large organizations in a variety of settings to develop, implement, and manage their employee wellness programs. Prior to joining Keenan, she worked in many different aspects of health management, including onsite wellness program management, community health initiative delivery for the Blue Zones Project, and health improvement consultation for a major health insurance carrier. She holds a Bachelor of Science degree in Kinesiology from California Polytechnic State University - San Luis Obispo and a Master of Public Health degree from San Jose State University, and has earned professional certifications from the American College of Sports Medicine in exercise physiology (ACSM EP-C) and the Chapman Institute in wellness program coordination (CWPC).