Avoiding Misdiagnosis: Why Multiple Opinions Matter
- Pageant queen and former University of Houston cheerleader Chloe Burke suffered cardiac arrest at just 21 years old, after years of experiencing symptoms which her doctors dismissed to her being a hypochondriac.
- More than a year after her near-fatal cardiac arrest, she was diagnosed with a congenital condition called myocardial bridging. Now she’s hoping her story can inspire others.
- Myocardial bridging is a a non-obstructive coronary artery disease (CAD) that can increase one’s risk of cardiac arrest if not managed well.
- When it comes to your health, sometimes it’s necessary to be a little pushy to get answers. SurvivorNet’s medical experts urge patients to advocate for their own health and seek multiple opinions if necessary.
Chloe Burke, a Texas pageant queen and former University of Houston cheerleader, experienced a potentially life-threatening cardiac arrest back when she was just 21 years old, ultimately leading to the discovery of a congenital condition she has called
myocardial bridging , a non-obstructive coronary artery disease (CAD) that can increase one's risk of cardiac arrest if not managed well. However, when she first complained of her unusual symptoms, doctors dismissed her as a hypochondriac and a "young overly dramatic girl." Now 25 and the titleholder of Houston's Miss Space City, Burke strives to raise awareness for Cardiomyopathy health and inform others about cardiac arrest signs and prevention.
Burke, who works with the American Heart Association to help share her story and inspire others to advocate for their health, recently spoke with
DailyMail.com about why she wants to spread the word. Looking back on when she had cardiac arrest while cheerleading at a game back in 2019, Burke, who also described herself as an avid athlete her whole life, recounted, "Everything went black."
RELATED: Is Hypertrophic Cardiomyopathy the #1 Killer of Student Athletes? How to Notice the Warning Signs of This Hidden Time Bomb Burke, who has no family history of heart issues, experienced the cardiac event on the University of Houston field, which led to her getting three electric shocks to restart her heart and open heart surgery. She ultimately didn't learn that she had myocardial bridging until more than a year later.
More On Misdiagnosis
According to
Stanford Healthcare , a myocardial bridge is a "usually harmless condition in which one or more of the coronary arteries goes through the heart muscle instead of lying on its surface" and in most cases, people with this condition don't notice symptoms. Looking back on when she first noticed symptoms, she said it began in her middle school years. She told DailyMail.com, "Any time my heart would pump, that artery would get squeezed in my body. My brain wouldn't get any oxygen, and then the more that artery was squeezed, the weaker the artery would become. "[My symptoms] became more aggressive as I got older. They were really aggressive in college. I was passing out multiple times a week, I was having to go to urgent care multiple times a week because I couldn't see anything." Burke continued, "Over the years, that artery was weakening because it was getting compressed all the time. The more I exerted myself, the more it would get compressed, and the weaker it would get. It just became worse and worse."
Offering some more insight into her condition to the
American Heart Association , Burke explained, "I experienced symptoms for years leading up to this, but went undiagnosed due to my age, gender, and lack of familial history with heart issues. "In fact, I was even told by doctors that I'm a hypochondriac and a young overly dramatic girl that would probably just grow out of it in a few years." She added, "So I kept pushing to find answers, and thank God I did or I may not be here today. Doctors told me that if I did not get open-heart surgery, I would most likely not live to see age 25. These experiences help me speak to adults, particularly women, on how to advocate for yourself and take the lead in your doctor-patient relationship. Burke was thankfully able to return to the football field just 11 weeks after her surgery — and she's been working to spread awareness to help prevent heart events like the one she endured from happening to others. She is even working to have a law made to bring CPR lessons and more access to automated external defibrillators (AED) in schools.
Following her life-saving surgery, Burke admitted that her recovery period wasn't easy as she learn how to "reuse all the muscles" in her chest after they were "ripped" during surgery. She also endured weeks of cardiac rehabilitation, and she remains grateful for her "mindset" and "determination" that led to a quick recovery. Despite all that she's been through she graduated college on time and with a superb GPA. Burke, who now works as a personal trainer, alongside her pageant titleholder duties and being a health advocate, told DailyMail.com, "I have to be very aware of my own body and what's going on in my body and know how to pace myself during certain things so I can avoid exhaustion that happens quicker. "When I am working out, or I am leading other people and fitness classes and things like that, I constantly know what's going on in my body and how to pace myself when I do hit those levels of sooner exhaustion and expect it from my heart, just getting too tired too quickly.' Burke, who checks her blood pressure on a daily basis and takes medication to regulate her blood pressure, has since been living life as she normally would, but making the most of it by working to inspire others and hopefully save lives.
‘Flourish’ A Story of Rediscovering One’s Inner Strength She concluded, "The more people that learn it, the more of a proactive culture and community you have around us, people who can act within seconds and save someone's life and save someone's quality of life."
How To Diagnose Myocardial Bridging
According to
Stanford Medicine , a myocardial bridge "can be difficult to identify on an angiogram or other traditional diagnostic tests, so it can be challenging to get to a correct diagnosis at many medical centers." The following tests may be conducted to get a diagnosis:
- Echocardiogram: an ultrasound exam
- Computerized tomography (CT) coronary angiogram: a radiation exam
- Cardiac catheterization: a minimally invasive procedure, when a thing tube called a catheter is placed in a blood vessel leading to the heart
- Intravascular ultrasound: when a small ultrasound device is placed into the artery
"Once we know that you have a myocardial bridge, we will conduct an additional test to establish if the bridge is blocking any blood flow and causing your chest pain," Stanford Medicine explains. The additional test is a Diastolic fractional flow reserve (FFR), which compares blood flow and pressure on each side of the myocardial bridge.
What are the Symptoms?
Symptoms of myocardial bridges may consist of:
- Angina (chest pain or tightness)
- Pain in the arms, back, neck, or jaw that mimics the pain of a heart blockage
- Shortness of breath
- Palpitations (irregular heart rhythm)
As for what causes this condition, Stanford Medicine explains, "People with myocardial bridges are usually born with them. However, most people with bridges do not even know they have them. In fact, people who experience chest pain from a myocardial bridge are often healthy and younger than most people with heart disease." The medical center notes on their website that people with myocardial bridges may not have the typical risk factors that those with heart disease have — like excess weight, high cholesterol, or a history of smoking.
Leading Experts Urge Patients to Be Proactive
As we highlight in several areas of SurvivorNet, highly respected doctors sometimes disagree on the right course of treatment for an ailment, and advances in medicine are always creating new options. Also, in some instances the specific course of treatment is not clear cut. That's even more reason why understanding the potential approaches to your disease is crucial.
RELATED: Burned Out Doctors Make More Mistakes: It's OK To Talk Openly About This With Them Cancer Research Legend Urges Patients to Get Multiple Opinions Furthermore, getting another opinion may also help you avoid doctor biases. For example, when seeking care for cancer, some surgeons may have an affiliation with a radiation center. "So there may be a conflict of interest if you present to a surgeon that is recommending radiation because there is some ownership of that type of facility," Dr. Jim Hu, director of robotic surgery at Weill Cornell Medical Center, previously told SurvivorNet. Other reasons to get a second opinion include:
- To see a doctor who has more experience treating your type of disease
- You have a rare disease
- There are several ways to treat your illness
- You feel like your doctor isn't listening to you, or isn't giving you good advice
- You have trouble understanding your doctor
- You don't like the treatment your doctor is recommending, or you're worried about its possible side effects
- Your insurance company wants you to get another medical opinion
Bottom line, being proactive about your health could be a matter of life or death. Learn as much as you can from as many experts as you can, so that you know that you did your best to take control of your health.
How Common Are Misdiagnoses?
Burke's story reminds us of a shocking study about how frequently patients are misdiagnosed. According to the study,
published in BMJ , an estimated 371,00 people in the U.S. die every year due to a misdiagnosis and around 424,000 people are permanently disabled. The study said an estimated 800,000 Americans in total suffer "serious harm" due to misdiagnosis every year.
RELATED: Teen's Ovarian Cancer Symptoms Misdiagnosed as Constipation -- Story Comes as Shock Study Shows 800,000 in U.S. Suffer 'Serious Harm' Due to Misdiagnosis Every Year The researchers for this particular study focused on "serious harm" but also noted that less detrimental misdiagnoses were likely occurring on an even grander scale.
According to STAT , authors believe the number of diagnostic errors that happen in the U.S. each year could be between 50 and 100 million. Despite these shocking numbers, most misdiagnoses do not have dire consequences.
Advocating for Yourself While Navigating the Medical World David Newman-Toker, the lead author of the paper, told the outlet, "The risk level just walking through the door in the doctor's office that something horrible is going to happen to you because of a diagnostic error is actually quite low."
Pushing For A Correct Diagnosis
When it comes to your health, be a little pushy. You know your body better than anyone else. When you see a doctor for a problem, don't hesitate to make sure that your question is fully answered and that you are comfortable with the plan moving forward. From a doctor's perspective, every problem should have a diagnosis, a treatment, a plan for follow-up, and a plan for what happens next if the treatment doesn't work. As a patient, if you don't feel like each of these four things has been accomplished, just ask! Even if it requires multiple visits or seeing additional providers for a second opinion, always be your own advocate.
Dr. Zuri Murrell , director of the Cedars-Sinai Colorectal Cancer Center, previously told SurvivorNet that healthcare guidelines are meant to do the right thing for the largest number of people while using the fewest resources. "The truth is you have to be in tune with your body, and you realize that you are not the statistic," he said.
Be Pushy, Be Your Own Advocate… Don't Settle Dr. Murrell says not every patient will "fit into" the mold, so it's important to "educate yourself and be your own health care advocate." "Every appointment you leave as a patient, there should be a plan for what the doc is going to do for you, and if that doesn't work, what the next plan is," Dr. Murrell said. "And I think that that's totally fair. And me as a health professional, that's what I do for all of my patients."
Contributing: SurvivorNet Staff 
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