From a New York Times Magazine article:
It was all horribly familiar — a rerun of an episode 15 months earlier, when she was with her family in River Vale, N.J. Back then, the burning pressure sent her to the emergency department, and she was told the same thing: She was having a heart attack. Immediately the cardiologist looked for blockages in the coronary arteries, which feed blood and oxygen to the hardworking muscles of her heart. That was the cause of most heart attacks. But they found no blockage.
Since childhood, she had frequent terrible canker sores that lasted for weeks. Sometimes it was hard to eat or even talk. Her mother, a nurse, told her everybody got them and thought she was being dramatic when she complained. So she had never brought them up with her doctors. Now the woman saw that her answer somehow made sense to the rheumatologist.
Indeed, that was the clue that led the rheumatologist to a likely diagnosis: Behcet’s disease. It’s an unusual inflammatory disorder characterized by joint pains, muscle pains and recurrent ulcers in mucus membranes throughout the body. Almost any part of the body can be involved — the eyes, the nose and lungs, the brain, the blood vessels, even the heart. Behcet’s was named after a Turkish dermatologist who in 1937 described a triad of clinical findings including canker sores (medically known as aphthous ulcers), genital ulcers and an inflammatory condition of the eye.
To read more: https://www.nytimes.com/2019/11/20/magazine/heart-attack-diagnosis.html?te=1&nl=the-new%20york%20times%20magazine&emc=edit_ma_20191122?campaign_id=52&instance_id=14017&segment_id=19010&user_id=415092ec82728104b9ca7bbb44eeb7d3®i_id=7441254120191122
Dr. Lisa Sanders crowdsources diagnoses for mysterious and rare medical conditions in a documentary series based on her New York Times Magazine column.
From a New York Times article by Lisa Sanders, M.D.:
In sarcoidosis, abnormal collections of cells called granulomas invade the organ, interfering with its normal activity and often destroying the surrounding tissue. What is left is a scar, known as fibrosis, dotted with these abnormal granulomas.
When caught early, sarcoidosis can be treated and the destruction slowed or even stopped. But it was too late for that in this man’s case. He was started on immune-suppressing medications to prevent additional damage, but he needed a new heart.
The man had been active and healthy, until five years earlier when he started to feel tired. His doctor sent him to a cardiologist, who took one look at his EKG and said he needed a pacemaker, right away. He got one the next day. He was fine for a year, and then, on a business trip to Atlanta, he suddenly felt lightheaded, and his heart fluttered wildly in his chest. In the E.R. they told him his heart was beating 220 beats a minute. You should be dead, one doctor said.
To read more click on the following link: https://www.nytimes.com/2019/08/22/magazine/why-was-the-middle-aged-mans-heart-beating-so-dangerously-fast.html
“The doctor asked whether he was sure that he had not taken anything else when he was sick? No acetaminophen? No herbs or supplements? The man was certain. Moreover, his labs were abnormal even before he took the antibiotics. The doctor hypothesized that the man’s liver had been a little inflamed from some minor injury — maybe a virus or other exposure — and the antibiotic, which is cleared through the liver, somehow added insult to injury.”
A few weeks before he got sick, he had blood tests for an application for life insurance. Days later, he heard from his doctor that his liver labs were a little off. There are enzymes in the liver that help with the organ’s work of cleansing the blood. When the liver is injured, these hardworking chemical assistants leak into the circulatory system. The levels of these enzymes, his doctor explained, were double what they should be.
Read more in the NY Times Magazine article by Lisa Sanders, M.D.: