I think that we need to redefine what is considered to be low-risk chest pain. If you have a young patient with a convincing ACS story, he or she may not make the cut for admission. “Sorry; we are not admitting a HEART score of 3.”
COVID is a great masquerader. In spite of vaccination and boosters, I experienced Delta and Omicron, each with a long trailing post-COVID syndrome. After the first episode, I did what many MDs do, "diagnosed myself" and ignored cardiopulmonary symptoms as a disregulated autonomic system. After all, what would anyone actually DO for me, anyway. The second time around, when intense chest pressure was added to the symptoms, I acquiesced to my family health history and personal risk factors and had discussion with my PMD who sent me off to the cardiologist for CAD screening. 3 months and several thousand dollars worth of diagnostics and I was gratified to learn that I did not appear to have significant coronary disease. BUT, I still have that family health history, personal predisposing conditions and frightful health maintenance habits. As an MD, I would advise anyone with my risk factors to take better care of themselves. I went to med school and all that training to advise and help others with their health issues. Perhaps if I had spent 12 years working on my own health preservation behaviors, I'd be a better patient...
I think that we need to redefine what is considered to be low-risk chest pain. If you have a young patient with a convincing ACS story, he or she may not make the cut for admission. “Sorry; we are not admitting a HEART score of 3.”
COVID is a great masquerader. In spite of vaccination and boosters, I experienced Delta and Omicron, each with a long trailing post-COVID syndrome. After the first episode, I did what many MDs do, "diagnosed myself" and ignored cardiopulmonary symptoms as a disregulated autonomic system. After all, what would anyone actually DO for me, anyway. The second time around, when intense chest pressure was added to the symptoms, I acquiesced to my family health history and personal risk factors and had discussion with my PMD who sent me off to the cardiologist for CAD screening. 3 months and several thousand dollars worth of diagnostics and I was gratified to learn that I did not appear to have significant coronary disease. BUT, I still have that family health history, personal predisposing conditions and frightful health maintenance habits. As an MD, I would advise anyone with my risk factors to take better care of themselves. I went to med school and all that training to advise and help others with their health issues. Perhaps if I had spent 12 years working on my own health preservation behaviors, I'd be a better patient...