Coronary Artery Disease, Judgment, and Interrogation


Carolyn Thomas of Victoria, Canada, was out for a morning stroll in 2008 when “out of the blue,” the 58-year-old felt sick. Pain engulfed the middle of her chest and radiated down her left arm. She was nauseous and sweaty.

The emergency room physician ran a number of heart tests, then informed Thomas: “You’re in the right demographic for acid reflux. Go home and see your family doctor for a prescription for antacids.”

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But popping antacids commonly for a few weeks did nothing for her signs. Thomas had burning acid reflux, lacked power to stroll, and felt as if she had a Mack truck parked on her chest.

Fearing that she was dying, Thomas returned to the ER. That’s when she realized that the ache in her chest and arm ache had been a widowmaker heart attack — 95 % of one in every of her coronary arteries was blocked.

A Shock to the Heart

Thomas and everybody who knew her have been shocked that she had extreme coronary artery disease (CAD). She was match, wholesome, and didn’t smoke. She discusses her case in her weblog, Heart Sisters, about girls and coronary heart illness.

“The most common question,” Thomas says, “was ‘How could you, of all people, have a heart attack?!’”

Her mates appeared to wish to imagine that Thomas, a distance runner for nearly 20 years, had someway introduced on the illness on herself.

“The questioner needs reassurance that this bad thing will not happen to them, so they seek answers to confirm their unrealistic belief that bad things happen to other people, not to me,” Thomas says.

But those on the other side of the interrogation, she says, can feel unfairly judged.

Heart attacks can happen to people who feel and look healthy. Most people with coronary artery disease have one or more risk factors, like high cholesterol or high blood pressure, and otherwise feel fine. But a small number don’t have any of the typical risk factors, says Deepak L. Bhatt, MD, executive director of interventional cardiovascular programs at Brigham and Women’s Hospital Heart & Vascular Center in Boston.

Thomas wonders if people would rather believe that she had a heart attack because she smoked or had diabetes. “It might mean that my heart disease was self-inflicted,” she says.

Two years after her coronary heart assault, Thomas found that she did have one thing that raised her possibilities for coronary heart illness: a historical past of dangerously hypertension (preeclampsia) throughout being pregnant. Early menopause and polycystic ovary syndrome are risk factors, too. These things are unpreventable and “certainly not self-inflicted,” Thomas says.

Thomas says that even if a classic risk factor such as obesity leads to heart disease, there still is no justification for judgmental attitudes.

“Blaming the patient is an attempt to reinforce the belief that this diagnosis could never touch me or my family,” she says.

Why Heart Disease Doesn’t Get Enough Love

You’ve probably heard that October is breast cancer awareness month. But Thomas says there’s a shocking unawareness of heart disease even though more women die of it in the U.S. than from all forms of cancer combined.

“Breast cancer is widely perceived as a tragic diagnosis that attacks the innocent out of the blue,” Thomas says. But heart disease remains misunderstood.

One Heart Sisters blog reader recalled a conversation between co-workers after her own heart attack:

“They were talking about breast cancer awareness. I said it was a worthy cause, but did they know that heart disease is actually the No. 1 killer of women? And one woman replied, ‘Yes, but you bring that on yourself. If you take care of yourself, you won’t have a heart problem!’”

Bhatt, the Brigham and Women’s doctor, isn’t surprised. “If patients have cancer, it is very rare for people to blame them for their disease. There is a bit more blaming that tends to happen with heart disease because the typical risk factors are widely known.

Escape the “Judgment Zone”

Thomas says it’s human nature for family, friends, and co-workers to express curiosity about major events. One way she handles the potential for too-nosey questions is to pick her listeners carefully. People you expect would be supportive may disappoint. Or you might find sympathetic ears from the unlikeliest places.

Ironically, your loved ones may not be the best listeners when you need to vent because they may be too worried about you. “These people want and need to hear us say we’re better now and getting back to normal and that our frightening health crisis is over so they can relax,” Thomas says.

Thomas also says you can choose whom you confide in. If you’re uncomfortable sharing, a generic response is fine. For example, say, “Thanks for asking. I’ll know extra about that after my heart specialist follow-up appointment.”

One of Thomas’s Heart Sisters readers prefers to simply say: “I’ve extra questions than solutions proper now.”

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