General responses to selected questions from Joel Braunstein, MD, of Johns Hopkins University and Joseph Toscano, MD.
Question:
My 53-year-old mother has been complaining of minor to moderate non-radiating chest pain recently, which she attributes to anxiety. I am an EMT and have been trying to get her to see a cardiologist or her MD. She adamantly refuses. This morning she was complaining of severe indigestion (it went away an hour later with Zantac) and has been complaining recently of fatigue. Is there any literature I can pass on to her about the seriousness of neglecting these symptoms? I have shared a variety of information with her, but nothing seems to work. We have a history of heart disease in our family. She doesn't smoke but suffers from hypertension. Please help before it is too late.
Answer:
As far as your (and her) family history of heart disease and hypertension, these are important, but just the fact that a person over 35 has recurring chest pain can be extremely significant. It may not be heart disease, but it's difficult to be sure without further evaluation.
You are in a common predicament. Whether or not your mother is having symptoms of heart disease, many people deny the possibility at first. There are a variety of reasons for this, but the most important point is to get the person to seek medical care, as you know and have been trying to get her to do. I'm not sure that there's any 100% reliable way to convince someone of this. It sounds like you have given her the facts (e.g., over 50% of heart attacks occur in those with no prior diagnosis of heart disease) and it hasn't worked. How about a different strategy:
- If you haven't already, talk to your mother as a daughter rather than as an EMT and from a caring, loving standpoint rather than an educational one. Emphasize that you want her to be alive and healthy for a long time rather than just, as an EMT, that you think she might be having a heart problem; that may sound to her like it's going to turn into an "I told you so" situation.
- Enlist the aid of other family members to do the same. If you are with her and she having sustained chest pain, call "911."
- If she trusts her doctor, ask him/her to speak with your mother. If she won't go in for an appointment, then see if the doctor will speak with her by phone.
- If she is reluctant to make an appointment, make one for her. Speak with the doctor to schedule it as soon as possible.
Good luck. I hope this helps. Better yet, I hope she agrees to an evaluation and it ends up being normal. Then she can say, "I told you so," but you'll feel a lot better about it!
