"Missed diagnosis in A&E despite glaring abnormalities"

I attended Caithness General Hospital A&E last year with severe tightness and burning pain in my chest, like a muscle spasm. I was also experiencing increased heart rate at rest and shortness of breath. This pain extended up into my left jaw and around my left shoulder and arm. It felt like I had reduced blood flow to my left arm, because I had pins and needles.

I had an ECG and chest xray and the Doctor reported they were both normal. No obvious problems with my heart or lungs. They felt it was likely heartburn and anxiety, because I have a history of anxiety and on palpation my stomach was very tender. I felt reassured because they were convinced I had nothing serious showing up on the tests they ran.

I recently received my medical notes and to my surprise, I discovered I actually had an abnormal ECG and my chest xray showed atelectasis (partial collapse) of my lower left lung. The ECG showed inverted T waves and prominent U waves as well as a prolonged QT interval, which are all clinically significant when accompanied by the physical symptoms I was experiencing!! I believe I was in fact experiencing angina when I presented at A&E but, perhaps because I have a history of anxiety, the Dr dismissed the ECG and xray findings as incidental. Despite the fact that the symptoms of atalectasis are chest pain and shortness of breath, exactly what I was experiencing!

Angina will often present differently in women than in men, notably it can happen at rest, as did mine, and also include epigastric pain and radiating pain into the arms and jaw. I have a strong family history of heart problems and symptoms consistent with long QT syndrome. I am now aware of episodes of reduced breathing/not breathing accompanied by myoclonic seizures while asleep. I’m also experiencing these same seizures while awake and I am unable to function because of the weakness and fatigue I’m experiencing, more than likely because my body is not getting sufficient oxygen!!

I also had a cardiology referral rejected in spring 2024 to investigate a possible POTS diagnosis as the Raigmore cardiologist was sure I was not suffering from any significant heart problems, without either seeing or speaking to me in person or doing any further investigations, such as echocardiogram or holter monitoring.

I've experienced what seems to be a definite trend in the medical community to immediately dismiss significant symptoms and rule out serious conditions when the patient is both female, known to experience anxiety and has a history of fainting/almost fainting. Yet there is a significant risk in the general population of cardiac disease and strokes. I think this needs to be taken very seriously because I know I am not the only middle aged woman to experience this sort of dismissal despite clear evidence pointing towards significant cardiac or pulmonary issues!! We need to be listened to, taken seriously and given more thorough investigations to ensure the correct care is given without prejudice!!