Evening star. [volume] (Washington, D.C.) 1854-1972, 1956-11-05
How to
STOP KILLING
YOURSELF
Much Heart Trouble Is Imaginary
By Or. PETER J. STEINcRoHN

Dear DR.. Steincrohn: Imagt-
nary heart trouble2 Just what
do you mean by that? / thought
you either had heart trouble or
you didn't. Where does imagina-
ton come into the picture?
Some time ago, in one of
your columns, I read that there
are millions of people in this
country who are unhappy need
lessly because they think they
have heart disease. Just what is
the distinction between heart
trouble and heart disease? I
know there must be many per-
sons like myself who are con-
| fused.
IF imaginary heart trouble is
not dangerous / don't under
stand why anybody should be
frightened by it. I will appre-
ciate anything you can say that
will clear up this problem for
me. And I'm sure that millions
of your readers will also be
thankful. Sincerely, Mrs. D. O."
Answer: It's my "guestimate"
that there are at least is million
people in the United States who
THINK they have heart disease
but HAVEN'T. I base this on my
experience as a cardiologist and
internist: Three out of every
four patients who come to me
THINKING they have bad
hearts have normal hearts.
You might call such people
nervous; or hypochondriacs; or
chosomatics";; or Just plain
scared. But I don't think they
should be dismissed with name
tags" that evade the problem.
When you label them sufferers
from imaginary heart trouble,
you Immediately catalogue them:
ID They suffer. ca They have
some trouble" related to the
heart.
Thorough Examination
When a patient comes to his
doctor complaining Of heart
symptoms, it is essential for the
doctor to make the most thor
ough Of examinations. A stetho-
Scopic examination is no longer
a complete cardiac evaluation.
First there must be time out
Tor an unhurried history taking.
And no examination deserves the
name unless the doctor takes an
ctrocardiograrn, does q fiuoro-
Iscopic, takes a chest X-ray, per-
forms a thorough physical and
orders the necessary laboratory
tests.
No matter what your doctors
reputation for excellence, he can
not hand down just verdict on
your heart unless he conducts
such an examination. Don't ac-
cept his report as a true one If
ne has based it entirely upon a
stethoscopic examination.
Now, what justifles the dag
nosis OF imaginary as against or
ganic treaD heart disease? II
your history and complete heart
study add up to mo organic find
ings," you should thankfully ac-
cept this decision. Too many
anxious people doubt the dag
nosis and continue to have imag-
mary heart trouble.
Heart Palpitation
If they have palpitation they
think their heart is weak. A
man said to me yesterday: "Ey-
cry time my heart skips, l think
1t will never start beating again,
Especially when it happens in
bed late at night. 1t seems like
an eternity before the next beat
comes. / go to sleep thinking
III Ole in my sleep"
II the doctod cannot convince
such a man that his heart is
normal - only irritable - you
have another case Of Imaginary
Heart Trouble added to the lonO
list.
Likewise, you may have other
heart symptoms" and not have
real heart disease. For example
consider such symptoms a.
ankle swelling; shortness OF
breath; chest pain; cough: IA
tigue; rapid heart beat-and
many others. Yes. these may be
found In patients with real
heart disease. But please re-
member. they may also occur In
the healthiest Of hearts.
Other Causes
Ankle swelling may be due q
the heat, or being on the feet
too long. Shortness Of breath &
often associated in those who
are too fat. Chest pain is no,
uncommonly a referred pain from
a diseased gallbladder. Cough
may be due to bronchitis. Fa-
tigue may be due to emotional
tension. Rapid heart may be
caused BY an over-aetive thy
! roid-
You zee. I hope. that having