Women who complain of chest pain are not nervous drug-seeking wrecks. This point seems to bounce off EVERY physician I have seen in the last 13 months, so let me say it again.
Women who complain of chest pain are not nervous drug-seeking wrecks.
OK, some may be. Some MEN might be too. But I am sick to death of being untreated or undertreated because I'm a girl and/or because I do have anxiety and/or because some doctor at some point decided I was a drug-seeker. When I'm in severe pain I do seek relief from it, so I suppose that could accurately be stated; however, I am also a treatment-seeker and all kinds of other things. I am finding "drug seeker" to be increasingly irritating. Some people have legitimate pain, and the people making stuff up to get narcotics are making life REALLY HARD for those of us who, on occasion, could really USE them.
Like this jackass who writes "If you come in for 'chest pain' I will not give you narcotics, rather I will give you nitro until your pressure bottoms out. You only get narcotics for chest pain if you get admitted." That's just great. Nitro makes people sick and gives them vile headaches. It's indicated if the pain is or may be from an MI, but if the cause is known to be a tachyarrhythmia, its use is simply punitive, and I think this tone makes that clear. You are punishing people for being in pain WHY? I feel punished for having cardiac issues to begin with. It is ruining my life. Why?? Narcotics reduce workload on the heart. NSAIDs, although good for some TYPES of chest pain, don't (and I'm a little bit doomed because I take other meds with which I can't even take ibuprofen, but I don't think that matters much in the grand scheme of things).
Pain aside, I'd like to review some basic cardiac physiology because it seems to escape notice. I thought that after an electrophysiologist mapped the crazy stuff going on my heart and ablated some of it, thus giving me a documented cardiac history, I would be done with the "it's just anxiety" crap. Alas. No.
The thing is that if your heart beats regularly and at length at 170 beats per minute, it doesn't really matter why. I have spent hours of my life arguing with doctors over whether it's SVT, fast sinus tach, some other kind of tach, caused by anxiety, caused by electrical derangement, caused because Saturn is out of alignment with Venus...IT DOES NOT MATTER. If your heart does that all the time, it gets tired like any other muscle and starts to hurt.
Unlike any other muscle, this one is responsible for oxygenating the body. If it's beating that fast, the ventricles can't fill. That means they can't pump enough blood out to the body. That means that not only the heart itself, but also everything else, is not getting easily or adequately oxygenated. The heart protests this treatment and hurts for that reason as well. Also, the left ventricle squeezes harder and harder to milk everything it can out of that ejection, so the walls thicken and it enlarges. You work a muscle harder, it gets bigger. Again, this is all cardiology 101. And what do we end up with when this goes on and on? Congestive heart failure.
So, after 13 months of this arguing and lying in hospital beds and taking this med and that med and that other med, having an ablation which did show SVT and not some other kind of tach and also some other kind of tach that can't be FIXED because it's right around my SA node, wearing a Holter monitor which showed "sure enough, your heart is pretty frequently up around 170," and having to spend entire days out of the week in bed because if I so much as twitch my heart zooms up so fast I can't breathe: I AM SICK OF YOUR CRAP, DOCTORS.
I'm sick of "you shouldn't be having chest pain so we aren't going to treat it." I'm sick of "you're just anxious." I'm sick of "just double this medication for the fourth time." I'm sick of "I know I said you needed a pacemaker, but you're really too young." I'm sick of no one considering this extreme, life-destroying fatigue to be a real problem. I'm sick of all of it.
I am not making it up. It is documented that I am not making it up. I don't know what else to do and am so frustrated that I just break down and sob. YOU try living like I live, so exhausted you can barely do anything you enjoy and sleep 10 to 12 hours a day. YOU try living in fear that "if I do that my heart will start racing and I'll be in pain for a week because no one will treat it." Try this. Stick your hand into your chest and squeeze for a while (think "Temple of Doom"). Do that for a couple of days. Now tell me you don't need pain medication. Tell me that you're not anxious just BECAUSE of the racing heart and pain.
In fact here's another vital signs 101 lesson. If you have a patient with a heart rate of 140 who has had fistfulls of calcium channel and beta blockers (resulting in a huge drop from 175 to 140) and STILL has a blood pressure of 140/90? They're probably in pain. Pain you should treat because there's that whole risk of sudden death from myopathy caused by tachyarrhythmias.
Remember MONA? Do that! Giving me aspirin and a few liters of fluid when there's no reason to send me further into CHF will not cover your ass for standard of care.