Discussions By Condition: I cannot get a diagnosis.

The ER sent me home.

Posted In: I cannot get a diagnosis. 3 Replies
  • Posted By: gennaubet
  • October 21, 2006
  • 00:46 AM

:confused: I hope someone can help me, I have been having intermitent chest pain for weeks, but recently I had this chest pain with sweating and nausea and a feeling like I was going to pass out. My boss sent me to the Emergency room, they did and EKG, chest xray and bloodwork and said my EKG was abnormal and that I had an enlarged heart. Shortly after telling me that they gave me an aspirin some advil and told me to schedule an appointment in the morning for a Stress test and an EChocardiogram. I called to schedule the next morning and the lady on the other end said they could not schedule my test's unless I come with 50% down due to me not having insurance coverage.. Now it's two weeks later and I keep having these episodes where I'll get Pain in my chest and feel instantly sick and dizzy like im going to pass out, it lasts about20 minutes then it seems to disapear. I am very worried and scared everytime I feel this pain come on and have no idea what is wrong with me other then them telling me my heart is enlarged. Iam 33 years old, past history of smoking, No current smoking, I take zoloft and ativan for anxiety and depression. Anyone have any idea how I can get these tests done when the hospital won't do it nor the cardiologist office who ordered the tests. It appears to me that if you don't have insurance you don't matter in the medical world.. P.S. A coworker was in the Emergency room next to me for chest pain, they kept her for observation that night and sent me home with my enlarged heart.. :confused:

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  • Sympathies- the American system sounds shocking. Over here we have the good old NHS and I would consider it unethical to refuse initial investigation for chest pain, as ability to pay is not an issue as healthcare is free at the point of need.At 33, it is rare (but not impossible) for it to be angina or a heart attack. I'd imagine that it's actually unlikely to be the heart (but heart muscle damage needs to be positively excluded). The exception to that is if you take cocaine. What are the proper names of zoloft and ativan? (we probably call them by a different brand over here)- certain antidepressants can cause rhythm disturbances. As for having an 'abnormal ECG'- there are various types of abnormalities- some sinister and many benign or incidental.With the feeling of being about to pass out that you describe, I would think of dysrhythmias (such as SVT or AF). Whereas a stress test would be important to exclude angina, and an echo would be important to exclude structural heart disease such as LVOT obstuction, cardiomyopathy and valve disease such as aortic stenosis, a 24-hour halter monitor may be of value.there are other, rarer causes but they don't quite fit what you've told me, and I would suggest the above investigations in the first instance.Sorry I can't be of more help to you in getting the investigations. If you were British, (from what you have told me) you would probably have them soon and without question- that's probably little consolation though
    Anonymous 42789 Replies
    • October 21, 2006
    • 10:34 AM
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  • Thank you for the response. the ativan is a tranquilizer I believe the proper name is lorazapam and zoloft is sertraline for depression. I was mostly concerned that they told me the chest xray showed I had an enlarged heart and the EKG showed a abnormality. BUT I know nothing . WHAT DOES THAT MEAN? Im so scared, does an enlarged heart or slighly enlarged heart mean I have something serious wrong? They told me the right side of my heart was slighty enlarged then sent me home, But with this chest pain and dizzyness coming and going im so terrified. Thank you for any response and help you can give.
    Anonymous 42789 Replies
    • October 21, 2006
    • 03:54 PM
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  • If it was diagnosed on a chest X-ray, I wouldn't generally be too worried. Was your X-ray taken with the cold film plate at your front or at your back? It makes a difference as X-rays taken with the plate at the back (AP films- Anteroposterior), there is a significant magnification of the cardiac shadow, and technically one should not comment on cardiac size. On top of that, there are problems with magnification, rotation and so on, so I wouldn't pay much credence to them saying there's an enlarged heart based on a single chest x-ray. Saying the right side of the heart is enlarged is difficult from a chest x-ray as the shadow can often be hidden by the left heart and the spinal column.ECG's often show abnormalities, and most of the time they are completely benign, and often normal variants that happen in some people but not in others. I very much doubt they would have sent you home if there was a serious abnormality. The comment on the right side of the heart or heart enlargement may have been made from the ECG (and/ or the chest x-ray), which might be suggestive of either a blood clot in the lungs (pulmonary embolus) in right heart strain or left ventricular hypertrophy (most commonly associated with high blood pressure, but occasionally other things such as a narrowing of one of the heart valves, or a bulk of muscle at the outflow tract of the left ventricle)Lorazepam and sertraline are both unlikely to be related to this
    Anonymous 42789 Replies
    • October 21, 2006
    • 09:36 PM
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