Doctors can confuse heartburn and heart disease, even in themselves

Most people are pretty good judges of what’s going on with their own bodies. But telling a heart attack from other causes of chest pain is tough stuff—even, it turns out, for highly trained doctors. That’s why I thought this personal story, written by a Harvard doctor who has heart disease, would make an interesting read. It’s an excerpt—the full version can be found in Heart Disease: A guide to preventing and treating coronary artery disease, an updated Special Health Report from Harvard Medical School.

Early one spring, I noticed a burning sensation high in my abdomen whenever I walked up a hill or worked out on the treadmill. I felt perfectly healthy otherwise. I had lots of energy and could do high-level exercise on the treadmill—once the burning sensation went away—without becoming short of breath. I thought it was just heartburn, so I started taking powerful acid-suppressing pills. They didn’t help.

Sometimes when I would feel the burning in my chest, I would remember an old saying to the effect that “A doctor who takes care of himself has a fool for a patient.” Still, I hesitated; I didn’t want to waste the time of a cardiologist if all I had was heartburn.

But one morning as I walked across the street from the garage to my office in the hospital, the burning sensation returned with a vengeance. When I got to the front door of the hospital, I was completely out of breath and couldn’t take another step. At that moment, the game was up: I knew I had heart disease, and that it was becoming worse.

I called my doctor. He ordered an exercise stress test that day. It was abnormal. The next day I had a cardiac catheterization. As I lay on the table, I watched the face of the cardiologist (a colleague of mine) as he performed the test. I saw him nod several times, and clench his jaw. Then he turned the video screen around so that I could see it, too. There, clear as day, was an ugly picture. Three different coronary arteries had blockages, and one showed an unstable, vulnerable plaque: a blood clot was forming at one blockage, threatening to shut down blood flow in the artery and cause a heart attack. I had seen such pictures many times before, but this time it was a picture of me.

The next day I underwent coronary artery bypass surgery. I was in superb hands, at a top hospital, and experienced no complications. Most important, although the vessels that supplied the heart with blood were diseased, we had caught the problem before a heart attack had injured my heart. My heart still pumps today as strongly as it did when I was 20.

Heart Disease covers everything you need to know about coronary artery disease, the manifestation of cholesterol-clogged arteries: what causes it, how to calculate your risk of having a heart attack, treating heart disease, the warning signs of a heart attack, and more. You can read the free online excerpt describing cardiac rehabilitation, which is about the best thing someone with heart disease can do for himself or herself. The report is available at /HH.