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Your Good Health: ECG won鈥檛 always reveal heart disease

Dear Dr. Roach: I recently went to my family doctor, complaining of left-arm pain and heartburn-like pain in my throat area. He said that he could admit me to the hospital for two days of testing or that it could be a pinched nerve in my neck.

Dear Dr. Roach: I recently went to my family doctor, complaining of left-arm pain and heartburn-like pain in my throat area. He said that he could admit me to the hospital for two days of testing or that it could be a pinched nerve in my neck. It was my choice not to go to the hospital, so he recommended meloxicam for a possible pinched nerve.

As it turns out, my symptoms later became so uncomfortable that I decided to go to the ER three days after seeing my doctor. It was a serious blockage of a main artery to my heart and emergency surgery was performed to put a stent in. I am lucky to have made it in time.

I realize that it was my decision to not be admitted. I guess I was in denial. I never thought to ask him if he could have given me an electrocardiogram in his office, and some people, including my intensive-care nurse, asked why he didn鈥檛.

Because he didn鈥檛 offer to test me in his office, I am considering changing doctors. I like him and he has always given me good care in the past, so I鈥檓 not sure what to do. I feel that had he done the ECG that day, my problem could have been diagnosed much sooner and possibly prevented my heart attack.

Why wouldn鈥檛 he have checked my heart function right there with the electrocardiogram? He did check my blood pressure and listen to my heart, but those seemed to be normal. Can you give me your opinion on this? I am a 64-year-old man.

F.M.

Without being there, I can鈥檛 give an opinion on whether your doctor should have insisted on you being admitted to the hospital, but I am printing your letter to once again emphasize that heart disease, even serious blockages, can have minimal or no symptoms.

It sounds like your doctor did suspect heart disease, and I bet he now regrets not insisting that you be admitted. It鈥檚 a judgment call, and you have to consider not only the symptoms but also the risk factors. Just being a 64-year-old man is a risk factor.

If you had other risks, such as elevated blood pressure, cholesterol, a history of smoking or a family history of heart disease, that would make heart disease more likely.

The electrocardiogram is not a perfect test, and although it might have been abnormal at the time, it also is possible that it could have been perfectly normal. In hindsight, I wonder if knowing your ECG was normal would have kept you from going to the emergency room when you did.

To me, this isn鈥檛 so egregious that I would suggest you find a different doctor, but only you can decide whether you still have confidence in him.

Dear Dr. Roach: Can you place plastics in the dishwasher? I have read that dangerous chemicals can be released from the plastic.

R.E.

Most plastics are safe, but you should put only plastics labelled 鈥渄ishwasher safe鈥 in the dishwasher, and placing on the top rack reduces the heat the plastic is subjected to. Never reuse any plastic that has been partially melted by a dishwasher or microwave.

Dear Dr. Roach: I am a woman who just turned 75, and I have a chronic dry cough. I visited my pulmonary doctor and he diagnosed bronchiectasis. There is no cure, but there are herbal products, such as Creseton. They claim to have a 90 per cent cure rate, which is better than no cure at all. Can you give me any suggestions or have you heard about the herbal products?

P.N.

Bronchiectasis is an uncommon lung condition in North America. It is a reaction to previous infection with a scarring process in the small airways. It is similar to chronic obstructive pulmonary disease. It鈥檚 more common in women and certain ethnic groups, or in conjunction with conditions such as cystic fibrosis or alpha-1 antitrypsin deficiency.

There is no way to reverse the scarring in the lungs once it occurs, but exacerbation of the disease can be both treated and sometimes prevented with antibiotics.

I looked up Creseton, and the company reported good results from its own, unpublished study. I can鈥檛 recommend the product on the basis of what the maker reported. I would like to believe it, but if something sounds too good to be true, it might be.