Episode 31: What to Say to Your Primary Care Physician When You’re Experiencing Chest Pain.

Have you ever wondered why some heart conditions slip through the cracks? I do. And myocardial bridges are one of those conditions. Join me as I speak with my very own primary care physician, Dr. Thomas Hopkins, more affectionately known as Dr. Tom. He joins us to unpack the mysteries of diagnosing chest pain in the hopes we can catch a symptomatic myocardial bridge sooner rather than later. With a journey that spans from aspiring heart surgeon to passionate primary care physician, Dr. Tom brings a unique perspective on cardiac health. This episode uncovers the critical importance of educating both patients and healthcare providers about myocardial bridges—a frequently misdianosed but potentially fatal condition. Dr. Tom walks us through a comprehensive approach to diagnosing chest pain, ensuring that no deadly condition is overlooked.

From initial assessments to advanced diagnostic tests, Dr. Tom explains the systematic pathway to accurately diagnose cardiac conditions from the perspective of a primary care physician or general practitioner. We delve into the limitations of primary care settings and the indispensable role of timely referrals to cardiologists. The urgency of quick action is highlighted, especially when conditions like myocardial bridging are suspected. This episode is a must-listen for anyone eager to understand the nuances of cardiac diagnostics and the vital need for vigilance in recognizing heart issues, especially if you or a loved one are experiencing chest pain that makes no sense.

Effective communication between patients and their physicians is paramount for accurate diagnosis and treatment. Dr. Tom emphasizes the importance of patients sharing their symptoms, risk factors, and behaviors openly with their doctors. He provides key questions to guide these conversations, ensuring timely interventions and specialist referrals. This episode not only highlights the clinical significance of myocardial bridges but also underscores the value of expressing gratitude for medical support. By fostering mutual respect and teamwork in the patient-doctor relationship, the greater the likelihood the condition can be diagnosed in a timely and proper manner to get the proper treatment before something more serious occurs. It’s both Dr. Tom’s and you know my belief, that there are many out there who are going to experience only one symptom from a myocardial bridge and that’s sudden cardiac arrest. Starting the conversation correctly from the beginning may just help save lives and improve lifestyles sooner for those getting proper diagnosis.

Here’s the website link to:  Dr. Thomas Hopkins

To learn more about myocardial bridges visit: My Imperfect Heart

To see our guests you can watch Imperfect Heart on YouTube

Episode Highlights(00:05 – 01:05) Medical Journey Towards Cardiac Surgery
(09:55 – 11:15) Diagnostic Tests for Chest Pain
(14:54 – 16:05) Patient-Doctor Interaction for Proper Diagnosis
(23:39 – 24:57) Addressing Patient Honesty and Care Coordination
(30:34 – 31:49) Connecting Patients With Myocardial Bridge

Chapter Summaries

(00:00) Diagnosing Chest Pain in Patients

This chapter welcomes Dr. Thomas Hopkins, also known as Dr. Tom, to discuss his transition from aspiring heart surgeon to primary care physician and his ongoing interest in cardiac health. We explore the topic of myocardial bridges—a condition not widely known even among medical professionals—and emphasize the importance of educating both patients and healthcare providers. Dr. Tom outlines the systematic approach his practice takes when a patient presents with chest pain, emphasizing the need to consider a broad range of potential causes, from cardiac issues to gastrointestinal and mental health factors. The goal is to ensure nothing potentially deadly is overlooked, using a comprehensive checklist that includes listening to the patient’s story, assessing risk factors, and understanding behaviors that might contribute to their symptoms.

(08:14) Diagnostic Pathway for Cardiac Conditions

This chapter explores the steps and considerations for diagnosing cardiac-related chest pain, emphasizing the importance of ruling out heart issues early due to their potential severity. We start with the initial assessments like listening to the patient’s symptoms and patterns of chest pain, and proceed to diagnostic tests such as EKGs, which provide a snapshot of heart activity, and stress tests, which offer a more dynamic view. Further, we discuss the limitations of primary care settings in conducting comprehensive cardiac evaluations and the crucial role of referrals to cardiologists for advanced diagnostics. Additionally, the importance of timely action and awareness of myocardial bridging as a growing concern in cardiac health is highlighted. The urgency of quick referrals to avoid catastrophic events, like heart attacks, underscores the need for vigilance and thorough examination when heart issues are suspected.

(14:54) What to Ask Your Doctor

This chapter emphasizes the critical importance of clear communication between patients and physicians for effective diagnosis and treatment, especially concerning heart conditions. We explore the necessity for patients to openly share their symptoms, risk factors, genetic history, and behaviors to avoid misdiagnosis and ensure timely intervention. Key questions patients should ask include whether their symptoms could be heart-related and the next steps for treatment, including referrals to specialists. The conversation highlights the value of early detection and the potential life-saving impact of thorough medical investigations, as illustrated by the example of myocardial bridge and the role of autopsies in uncovering undiagnosed heart issues. The overarching message is the urgency of addressing symptoms that interfere with quality of life and the proactive role patients must take in their healthcare journey.

(28:23) Myocardial Bridge

This chapter explores the clinical significance of myocardial bridges, emphasizing that despite their congenital nature and rarity, they are not benign and can lead to fatal myocardial infarctions and sudden cardiac deaths through arrhythmias. We highlight the importance of education and awareness among healthcare professionals, particularly primary care physicians and cardiologists, to consider myocardial bridges as a potential cause of cardiac symptoms even in patients who appear otherwise healthy and are not typical candidates for heart conditions. The discussion underscores the need for thorough evaluations and appropriate referrals to ensure that patients receive the necessary studies to identify this condition. Additionally, the value of holistic health approaches and effective communication within the medical community is emphasized to improve patient outcomes.

(32:48) Expressing Gratitude for Medical Support

This chapter explores the importance of communication between patients and their primary care physicians (PCPs). We discuss how sharing personal experiences and concerns can help bridge the knowledge gap, even for esteemed doctors. Acknowledging the limitations of PCPs and expressing gratitude for their efforts fosters a better understanding and trust. Highlighting the significance of increasing awareness, knowledge, and education about specific medical conditions, we emphasize the positive impact this has on patients’ lives. The conversation underscores the value of teamwork and mutual respect in the patient-doctor relationship, ultimately benefiting the broader community.