A Post ER Follow-Up Could Save Your Life

Even if you didn’t have a heart attack, see your doctor

doctor holding stethoscope

Even if Emergency Room doctors say you didn’t actually have a heart attack, that doesn’t mean you have a clean bill of health. You should still follow up with your doctor.

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As originally reported by Reuters, recent studies confirm that chest pain patients who followed up with a doctor visit after their ER-release fared better in the next year than those who “swept the worry under the rug.”

What sent you to the ER?

Heart attacks happen when narrowed arteries block adequate blood flow to the heart. All heart attacks are medical emergencies. You should immediately call 911 if you see any signs that make you think you are having a heart attack, including:

  • A heavy feeling or pressure in the chest.
  • Pain in the chest that can radiate to the left arm or jaw.
  • Severe heartburn-like symptoms.
  • Extreme sweating and nausea.
  • Extreme fatigue, fainting, anxiety or rapid heartbeat.

There are many different conditions that mimic some of the classic signs of a heart attack. And some patients fearing a heart attack receive the good news that they have not in fact had one.

However, even if you get a “pass” on the diagnosis of heart attack, there might be other underlying issues that could cause complications later on. It’s much better to visit your doctor or cardiologist soon after your release. A follow-up visit can keep you from ending up back in the ER again.

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Canada study: more than common sense

A Canada-based study looked at how patients released from the ER (with no evidence of heart attack) fared one year after going to the ER complaining of chest pain. The patients who afterwards saw a heart specialist had better health outcomes that those who didn’t. Specifically, they were less likely to have a heart attack or die in the next year.

Out of the approximately 200,000 low-risk chest pain subjects studied, almost one third didn’t see a doctor after being released from the ER. Study subjects who went to see a cardiologist after their release from the ER had a 15 percent lower risk of heart attack or death in the following year. Subjects who saw both a primary physician and a cardiologist had an almost 20 percent lower risk. Results appear in the American Heart Journal.

Wishful thinking

Researchers think that some patients see a release from the ER as proof of their good health.

But often the exact cause of chest pain or other symptoms can’t be determined in the ER. If there is no sign of a heart attack, then there isn’t an immediate emergency. But that doesn’t mean that you can ignore risk factors such as high blood pressure, diabetes, having a poor diet or being a smoker. These are all factors that need treatment and careful management.

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Other factors at play

Cardiologist Umesh N. Khot, MD, did not participate in the study but he reviewed it. He notes that even in Canada, where all medical treatment is free, “One of the most striking findings is that … 29 percent of patients did not follow up with any doctor after having chest pain.”

That high number indicates inhibiting factors at play other than money — factors that could cost patients their lives. “We tend to think that cost is the major barrier, but this research indicates there are other barriers. In the U.S. these might include language and cultural barriers as well as other illnesses and burdens,” Dr. Khot says.

“It’s very important that the ER physician has the time to clearly communicate with the patient about the importance of following up with a physician and a cardiologist, after discharge. This should be a clear recommendation — one that the patient must take seriously — and the study results confirm this,” he says.

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