Heart Attack!

[doc henderson]

If you are old and have risk, like smoking, htn, high cholesterol, diabetes, you should get a stress test.  Lots of things cause costo.  anything inflammatory.

[doc henderson]

he was right, based on the pic.  he was in Mexico.  he had diarrhea.  I was happy to have a froze up AC that just needed the filters cleaned.

[doc henderson]

@metalspinner I just saw your question.  We look at risk stratification.  family history (often confounded as most men smoked back in the day), symptoms, age, other illness (high blood pressure, diabetes, high cholesterol, previous heart attack or stroke).  We can do a walking stress test, a chemical induced stress if you cannot walk well, and a combined stress test with echocardiogram.  If symptoms are significant (not all and in fact most "chest pain" is not coronary disease and a heart attack waiting to happen), we may go straight to heart cath.  If the EKG shows a st elevation MI (STEMI) go to cath.  Slight elevation in the heart enzyme Troponin, then a cath the next day, on heparin in the hospital.

[doc henderson]

Sorry Peter, just saw your question.  they had chest pain, and their EKG showed ST elevation, so they went to heart catheterization within 20 minutes.  they used to call the ST elevation that looked like rectangle "tombstones", but success is very good these days, and most folks do not die, and do recover.  The abbreviation for ST elevation myocardial infarction is STEMI.