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DEAR DR. ROACH: I had a very unpleasant experience a few days ago, and I’d like your opinion. I am 90 years old and was awakened early in the morning with an extreme heaviness in my chest. I have a concierge physician, and they told me that if I was able to drive, I should come right over to the office, where I had my blood pressure taken, as well as an electrocardiogram (EKG) and blood work done.
I did this, and I was then told to go home and wait to find out if I’d had a heart attack (as markers in the blood would confirm). As I was leaving the office, the doctor gave me a nitroglycerin tablet to put under my tongue, and I passed out. (I had never fainted before in my life.)
When I came to, I was on the floor, and there were men moving me onto a gurney and taking me to an ambulance. I was in the emergency room for over four hours, and every test came back negative. I had to get a ride back to retrieve my car at the doctor’s office and finally returned home after a very traumatic experience.
My question to you is, why was I given nitroglycerine when the heart attack hadn’t been confirmed? I’ve since done research, which has shwon me that none of this should’ve happened. In hindsight, we think it was acid reflux. -- B.K.
ANSWER: I think there were several errors along the way. The first one is that the sudden onset of extreme heaviness in your chest should’ve prompted you to call 911, not your physician. Paramedics would likely get there much faster and are experts in the emergency treatment of acute coronary syndromes. They have the necessary equipment and training to treat you correctly if your heart stopped.
I’ve known too many people who died while driving themselves to the hospital or to their doctor. The doctor should have called 911 on your behalf or told you to do so. I also disagree with sending you home while your doctor was waiting for the results of your blood tests. If your doctor was worried enough to order these tests, you should’ve been in a monitored setting until they came back negative.
Giving nitroglycerine to a person with extreme chest heaviness who had a strongly suspected heart attack is sometimes appropriate, even before the EKG or blood tests confirm the diagnosis. It sounds like your doctor did check your blood pressure before giving it to you, and hopefully, they listened to your heart to check for valve problems before giving it to you.
However, they shouldn’t have sent you out immediately after giving you nitroglycerine. It’s an extremely powerful drug, and we shouldn’t give it to any patient on their way out of the office. At age 90, a drop in blood pressure should’ve been predicted, and you should’ve been in a controlled situation.
Doctor’s offices in general aren’t set up to optimally deal with a heart attack. With such a concerning story, you should’ve been in an ambulance as soon as possible, then to an emergency room with appropriate monitoring and resuscitation equipment that is immediately available. People who are at risk for heart disease (even with just their age) should call 911 with symptoms concerning a heart attack.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2026 North America Syndicate Inc.
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