Med-Surg Topic of the Week ..... You Decide!

Long Term Care Columnist / Guide · Feb 12, 2005

How about differential diagnosis of chest pain? :idea: Seeing as 'broken heart' syndrome has been in the news this week (and I spent three days in the hospital this same week undergoing tests to learn the cause of my own chest pain), I'd like to read others' opinions on this common but complex symptom. Anyone?

RNPATL, DNP, RN · Feb 12, 2005

How about differential diagnosis of chest pain? Seeing as 'broken heart' syndrome has been in the news this week (and I spent three days in the hospital this same week undergoing tests to learn the cause of my own chest pain), I'd like to read others' opinions on this common but complex symptom. Anyone?

Did you have the broken heart syndrome? I also saw this on the news and was facinated by it. Amazing that the heart's pumping action can be affected by our own emoitions and the body's response to stress.

I have had a number of patients that have been young that have ben admitted with chest pain (23 hour obs) .... never really saw them looking at broken heart syndrome. I wonder how long this syndrome has been known and when they first started to diagnose it?

By the way, I also saw this on the news this week and was amazed.

UM Review RN, ASN, RN · Feb 12, 2005

I wonder how long this syndrome has been known and when they first started to diagnose it?

I've seen quite a few patients admitted who have chest pain caused by bad relationships or the death of a spouse. Some of them also have panic attacks, but not all.

The "broken heart" syndrome is one that I've seen because in FL we have a disproportionately high number of elders. We say that those folks "just give up," and even though we do what we can, some of them want to die--and do.

UM Review RN, ASN, RN · Feb 12, 2005

I wonder if the stress of having a broken heart can cause coronary vessel spasm, which can cause ischemia and angina, and lessen O2 flow to the heart?

Or if maybe the person suffering simply doesn't care to get the early warning s/s treated without someone to urge them to see a doc?

We get a lot of depressed spouses after their partner dies, especially in the first year.

Marie_LPN, RN, LPN, RN · Feb 12, 2005

I wonder if the stress of having a broken heart can cause coronary vessel spasm, which can cause ischemia and angina, and lessen O2 flow to the heart?

I think it would.

RNPATL, DNP, RN · Feb 12, 2005

I wonder if the stress of having a broken heart can cause coronary vessel spasm, which can cause ischemia and angina, and lessen O2 flow to the heart?
Or if maybe the person suffering simply doesn't care to get the early warning s/s treated without someone to urge them to see a doc?
We get a lot of depressed spouses after their partner dies, especially in the first year.

Excellent point! Many patients with CAD and acute MI's have terrible depression. The term cardiac cripple is certainly very real! Ask any Cardiac Rehab Nurse and they will tell you that as a part of recovery for a patient with CAD, counseling in very mush a part of their program.

I agree with the elderly statement in Florida .... when I worked open heart, in Florida .... many of my patients (single, little to no contact with family) would often question why they even had the surgery. Of course, after the Cardiac Rehab nurses got a hold of them ... they were a lot happier ... love those cardiac rehab nurses .. they spread a lot of joy!

Long Term Care Columnist / Guide · Feb 12, 2005

Did you have the broken heart syndrome? I also saw this on the news and was facinated by it. Amazing that the heart's pumping action can be affected by our own emoitions and the body's response to stress.

No, they think I had a form of viral myocarditis, secondary to the flu/bronchitis I had several weeks ago. Although I guess you could say I'm chronically under stress.......always too much going on, working too hard, worrying about my kids (including my 'extra' one, the SIL to be), my sister's poor health, our finances, etc. etc. I guess I didn't really take it into consideration before I was hospitalized, mainly because I've felt pretty serene and content with my life compared with what it used to be like! But several of my friends and co-workers pointed it out (one of them said "Good Lord, Marla, what do YOU consider stress ??!!") so I've had to pay attention to the fact that I really do not take good care of myself.

Time to change that. :) Wish me luck.......treating myself like crap just comes naturally, I guess, and it'll be a hard habit to break. :uhoh3:

RNPATL, DNP, RN · Feb 12, 2005

No, they think I had a form of viral myocarditis, secondary to the flu/bronchitis I had several weeks ago. Although I guess you could say I'm chronically under stress.......always too much going on, working too hard, worrying about my kids (including my 'extra' one, the SIL to be), my sister's poor health, our finances, etc. etc. I guess I didn't really take it into consideration before I was hospitalized, mainly because I've felt pretty serene and content with my life compared with what it used to be like! But several of my friends and co-workers pointed it out (one of them said "Good Lord, Marla, what do YOU consider stress ??!!") so I've had to pay attention to the fact that I really do not take good care of myself.
Time to change that. :) Wish me luck.......treating myself like crap just comes naturally, I guess, and it'll be a hard habit to break.

Wow .. yes, it is important to take care of yourself ... you are important to many people in your life!

Why is it that nurses do not take better care of themselves? Is it because we are so use to sickness that we are immune to the fact that we could be the one in that bed?

As far as stress is concerned ..... it is amazing that as nurses, we have grown so use to stress that sometimes we do not even realize that the stress in our lives and on the job would be overwhelming to other people. Yes, stress is very important to recognize and plays havoc with our hearts.

Please take good care of yourself! You are worth it.

Long Term Care Columnist / Guide · Feb 13, 2005

Thanks, Pat. :kiss

I just woke up from a nap (again) and am now sitting at the computer eating some mixed veggies and an orange. I'm trying not to think of it as dieting or depriving myself....after all, fruit and veggies are delicious!! I'm going to work on convincing myself instead that I'm feeding my body what it wants and needs to be healthy, not punishing myself for past transgressions. It's time to throw out all that old, negative thinking.....I've got to look at this as the opportunity to finally get it right, to treat my body with the love and respect it deserves. :wink2:

steelcityrn, RN · Feb 13, 2005

Sorry to neb on your conversation, but wanted to say...YOU GO GIRL:) EAT THOSE VEGGIES AND ORANGES...LOL...nothing like a good positive attitude....refreshing:)

Thanks, Pat. :kiss
I just woke up from a nap (again) and am now sitting at the computer eating some mixed veggies and an orange. I'm trying not to think of it as dieting or depriving myself....after all, fruit and veggies are delicious!! I'm going to work on convincing myself instead that I'm feeding my body what it wants and needs to be healthy, not punishing myself for past transgressions. It's time to throw out all that old, negative thinking.....I've got to look at this as the opportunity to finally get it right, to treat my body with the love and respect it deserves. :wink2:

barefootlady, ADN, RN · Feb 13, 2005

After my spouses recent hospitalization, I know that some of the newer nurses do not have a clear idea of how to do dressings, when dressings need to be done, things to look for post op, and how to teach family wound care.

I am upset at the lack of universal precautions being used by so many nurses. Good thing I am a nurse, a normal person without any training would have a hard time with his post hospital care right now.