In article <[log in to unmask]>, [log in to unmask] writes
>Distinguishing between peptic/oesophageal pain vs. Heart attack seems (usualy)
>simple. One guy is scared to death, often litteraly, while the other has
>often been on the booze.
Well I hate to do my wise old owl bit - but much as the books may agree
I think a lot of clinicians may not.
I have seen MIs present as all sorts - and dyspepsia likewise.
I am not sure the ecg always helps either though.
Jel's art of medicine - first, do not pretend it is easy - second,
assume you are likely to be wrong a lot of the time - third, dont
beleive what you read in the textbooks of mythology - fourth, develop
your gut feelings for they are more than just this.
One that I came across (a year or so back and in another location to my
current one) was the sunday afternoon request for a visit by a woman who
had had toothache for a week on and off - I wont usually see these and
tell 'em to phone the dentist - but something must have jangled
somewhere and I asked her to come to the surgery at 5pm - she didnt
arrive. (It later came to light that she had gone out and then on to
the pub for the evening later - I guess that as I had not instantly
delivered antibiotics she had decided that her social life was more
important (loads of this in GP land))
Next day she pitched up to see the doctor at surgery - still with R
sided lower 'toothache' - he also had a feeling about her and did an ECG
- the woman left the surgery before he had been shown the ecg - the doc
looked at the ecg, recognised her infarct, went round to her house but
unfortunately she had died.
So beleive me - it is not easy.
Cheers :-)
--
Dr Jel Coward
'There's no such thing as bad weather - just bad clothing"
Anon Norwegian
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