Summary

A patient with a history of hypertension was misdiagnosed with an anxiety attack during a heart attack and sent home from the ER without proper testing, only to later discover the misdiagnosis when a subsequent ER visit revealed evidence of a prior myocardial infarction.

Abstract

The individual experienced severe chest pain and high blood pressure, prompting a visit to urgent care, where they were advised to go directly to the ER. Despite expressing concerns about potential heart issues, the ER staff attributed the symptoms to anxiety due to the patient's medical history, which included anxiety and hypertension. The patient was prescribed medication for anxiety and high blood pressure and sent home without further diagnostic tests. Months later, during a follow-up visit with different medical personnel, an ECG confirmed that the patient had previously suffered a minor heart attack, which had likely occurred during the initial misdiagnosed event. The patient reflected on the importance of self-advocacy and the potential life-threatening consequences of dismissing heart attack symptoms as anxiety.

Opinions

The patient believes that their symptoms were not taken seriously by the ER staff, which led to a misdiagnosis.
The patient feels that the ER staff's decision to focus on their history of anxiety rather than their reported symptoms was a critical error.
The patient is critical of the healthcare system for not providing adequate care and for the potential risk this misdiagnosis could have posed to their life.
The patient is adamant about the importance of persisting to receive proper medical attention when experiencing severe health symptoms, despite being initially dismissed by medical professionals.
The patient expresses frustration over the lack of continuity in care, as their extensive medical history, which was available in their electronic health file, was not adequately considered during the initial ER visit.

I Was Sent Home During a Heart Attack Because Doctors Thought I Was Having an Anxiety Attack

I’m lucky it was a minor myocardial infarction

I cringed in pain as I took a breath. My chest was tight, and I felt like I wasn’t getting enough air. A burning sensation shot up my arm even though I wasn’t doing anything strenuous. Something was wrong.

I grabbed my blood pressure cuff and did a quick reading. As I suspected, my blood pressure was high — 192 over 122. I remembered my doctor telling me to always seek immediate medical attention anytime the top number was at least 180, so I grabbed my shoes and jumped in the car.

I drove to urgent care and was taken to a room immediately. The nurse’s eyes widened in surprise as she removed my blood pressure cuff, and she said,

“We’ll refund you for today’s visit because we can’t help you here. You need to go straight to the ER because your blood pressure is so high. Do you have a ride?”

“Yes,” I lied, walking out to my car. I called my friend and asked if she could meet me at the hospital for support, then explained why.

“No way!,” she screamed. “Do not drive yourself! It’s not safe. Wait there — I’m out running errands right by you. I’ll pick you up in a minute and take you to the ER.”

The wait was short at the ER — just 30 or 45 minutes. I sat in my seat, sweating, trying to get rid of the discomfort in my chest. I didn’t know what was wrong, but I was scared I was about to have a stroke. I tried doing some deep breathing to calm myself, but it didn’t help. I was getting worse by the minute.

“Missy?” a nurse asked, scanning the room. I walked over to her, and she took me to a private room.

“What’s going on today?” she asked, scanning my forehead with a thermometer. I explained that I was diagnosed with blood pressure more than 10 years ago and had recently run out of my medication, which my doctor refused to refill without an appointment. My doctor had no immediate appointments available, plus I was uninsured and couldn’t afford the twice-a-month blood pressure checks with her nurse practitioner, so I’d been off my meds for a couple of months.

The ER nurse took my blood pressure and said, “Well, it is high, but I see in your file that you have a history of anxiety. I think you are just anxious right now, and that’s making your blood pressure worse.”

“I’m anxious about the pain, but this feels different. I’ve had high blood pressure since my early 20s, and I’ve never felt like this. That’s why I came to the hospital,” I explained.

“Well, let’s get you a prescription for your anxiety and blood pressure meds, and then we’ll send you home so you can rest.”

“Can’t you do a chest X-ray or whatever you use to check this type of thing? I feel like I’m having a heart attack or something. The pain is in my chest and arm. I just don’t feel like myself.”

“Oh honey, anxiety attacks can feel just like heart attacks. Don’t worry, we’ll get you a 30-day supply of the Buspar so your anxiety calms down until you’re able to get into a doctor. You’re too young to have a heart attack.”

I left with a handful of prescriptions, feeling like I was going to faint. My friend drove me home and made me promise to call her throughout the evening so she knew I was okay. She didn’t trust the hospital, and she was right to be suspicious of their care. I didn’t learn this until a few months later.

My blood pressure was high again, so I headed to the ER at my doctor’s recommendation. I was insured this time, but I had an allergic reaction to my blood pressure medication and had to start a new one. The new one was less effective, so I had to switch again. In the meantime, my blood pressure was out of control, and I wanted to make sure everything was okay with my heart.

I headed to the ER, but this time, I was greeted by a medical team who took my concerns seriously. They ran several tests, including an ECG which showed evidence of prior myocardial infarction. Simply put, it means I had a heart attack in the past but was not experiencing one at the time of the test.

I was furious. I wasn’t having a heart attack now, which was great news, but I had experienced one in the past. I knew exactly when it happened, too — the time my concerns were ignored and blamed on anxiety. I shared my thoughts with my medical team, and they agreed that I was most likely correct based on the symptoms I had experienced that night.

I have an extensive history of stage 2 hypertension, including documented systolic numbers as high as the 230s. I remember one of those visits clearly because the doctor said I was lucky I didn’t have a stroke. She also explained your heart can stop beating when the systolic reading hits 280.

These visits were all referenced in my electronic health file — the same one the nurse was looking at when she mentioned my history of anxiety in the ER. The same file that showed I had been on blood pressure medication since my early 20s and had several hospital visits for kidney problems. The same file that showed I was overweight, which was another risk factor for heart disease.

There’s no reason I should have been sent home the day of my heart attack. I’m thankful it was a minor one that didn’t trigger any serious complications, but what if I hadn’t been that lucky? Blaming my heart attack symptoms on mental illness could have cost me my life.

My anxiety makes me worry about potential issues that could happen, but it doesn’t make me imagine symptoms. I know when something isn’t right with my body. If chest pain ever strikes again, I’m not leaving the hospital without demanding some diagnostic tests. It’s too risky not to advocate for myself.