My heart condition was dismissed as me being fat and anxious

Leah Rachel von Essen’s heart condition went undiagnosed for five weeks, because doctors dismissed her symptoms as being due to her weight and mental health

The first doctor I saw gave me allergy medicine. The second told me that my “mysterious illness” would go away with diet and exercise, and patted his stomach as he said so, as I tried to explain that I’d been working out often before I got sick. The third doctor recommended that I get help for my panic attacks — and completely ignored me when I tried to explain that the symptoms I was experiencing were nothing like my anxiety.

None of this was new to me. I’m a fat woman: at my thinnest (and most unhealthy), I weighed under 140 lbs, and at my heaviest, I’ve hit 240 lbs. But despite what doctors might think, I’ve never been unhealthy. I was a varsity athlete in high school and college — I’m not anymore, but I walk 50 minutes each day, and work out a couple of times per week. My meals can still be a bit college-athlete-sized, and I have a sweet tooth, but I eat a balanced diet full of fruits, whole grains, and vegetables.

Unfortunately, none of those facts matter to many of the doctors I’ve seen over the years: all they see is the number on the weight scale and the word “anxiety” written on my chart. When I experience a symptom I’m concerned about, doctors either dismiss this on account of my anxiety or attribute it to my weight. I’ve gone undiagnosed for some time with conditions including strep throat, flu, and a sprained ankle because of doctors who dismissed me for one or both of those reasons.

Nothing is more panic inducing than feeling like you can’t breathe and knowing that if you tell a doctor, they might very well tell you it’s all in your head

As a result, I’ve spent years learning how to get doctors to hear me out. I have to be stubborn and informed but also calm and kind, so that they don’t think I’m exaggerating. It might have been funny that the third doctor sent me home with a pamphlet on breathing exercises (which I swiftly recycled), if I wasn’t finding my symptoms terrifying.

In September 2019, after a bad sinus infection followed by a nasty cold, I started feeling exhausted, which I initially thought was a sign that I was slowly recovering. But then, every time I’d lie down, my heart rate would rocket. Soon, my heart started feeling like it was beating out of my chest — even during the day.

My symptoms were worsening. I had to take days off work because of brain fog, which left me disoriented and unable to focus my eyes. In addition to my pounding heart, I started getting stabbing chest pains under my left breast. I would feel faint if I climbed even a single set of stairs.

This when my anxiety actually began to enter the picture: nothing is more panic inducing than feeling like you can’t breathe and knowing that if you tell a doctor, they might very well tell you it’s all in your head.

I silently prayed for any diagnosis. I no longer cared about the result itself: I just wanted confirmation that this was not in my head

I started doing my own research, and the next doctor I saw resented this. I insisted on a couple of tests, including for mono and flu, but they all came back negative.

My new theory was that it could be bronchitis. The urgent care doctor I went to see ordered a chest X-ray, but he was clearly skeptical about the need to do so. It came back clear. Then, he asked: “Who told you that you should be on Zoloft?”

Zoloft is an antidepressant I had been taking for months. He had decided that my symptoms were either due to my anxiety or to my antidepressants. He told me to never again trust my psychiatrist’s prescriptions without running them by a general practitioner. I begged him to consider other options, but he refused.

Then, I went to my psychiatrist, who sent me straight to a cardiologist.

By the time I visited the cardiology office, I had been hurting for over a month. I silently prayed for any diagnosis. I no longer cared about the result itself: I just wanted confirmation that this was not in my head.

When the cardiologist came in, I started nervously reading him two pages of meticulous notes that I’d brought with me, detailing my symptoms and the tests and diagnoses I’d been given so far. When he interrupted me, a spike of dread rose in my stomach.

“Can I read those, actually?” he asked and started copying them into my chart. That’s when I knew I was going to be okay.

I am an anxious, fat woman, and the onus fell on me to convince doctors that my symptoms were real

The diagnosis was pericarditis, which is when the sac of tissue around the heart (pericardium) becomes inflamed. My heart was fine, but the swollen pericardium, a result of my immune system reacting poorly from my double illness in September, caused friction in my chest, leading to the discomfort and other symptoms I’d been experiencing.

“Please be honest with me,” I said. “Does this have anything to do with my weight, or with anxiety?”

“No,” he said firmly. “If you had other heart conditions, maybe, but your heart is fine — just look at this perfect EKG. This was just bad luck.”

My pericarditis was just bad luck, but the month I spent undiagnosed and dismissed was the result of me being left to figure it out myself: to do the research and contend with harmful assumptions about my weight and anxiety, all in order to have a doctor give me the basic courtesy of believing that something is wrong in my body. Pericarditis can have serious complications if left untreated, and mine was left for five weeks.

I am an anxious, fat woman, and the onus fell on me to convince doctors that my symptoms were real, and not a result of my weight or mental health. But I did fight, and I got answers. I came out of the cardiologist’s office beaming, with a diagnosis and a prescription in my hand. Since November 2019, I’ve been taking colchicine and slowly healing, teaching myself to trust my body and recognise when the pericarditis is hitting me hard. I’ve also been channeling my anxieties and fears into researching the ways that the healthcare system fails women and other marginalised populations. I’ve been healing my pericarditis, and me, from the inside out.
 
 
Featured image is a black and white illustration of a fat woman, wearing a long-sleeve shirt and high-waisted skirt. Her right hand is resting on her chest, as if she’s in pain. There is an illustration of her heart that is coloured in red and pink, contrasting with the black and white figures, that appears on her left side and just next to her hand. On her left, a hand reaches out to offer her an apple; on her right, another hand offers her a phone with a relaxation app on it
 
 
Page last updated March 2021

Leah Rachel von Essen

Leah Rachel von Essen is an editor, writer, and book reviewer. She reviews genre-bending and fantastical fiction for Booklist, and writes regularly at Book Riot on topics including books in translation and the biases in mental health and medicine. Her blog, While Reading and Walking, features content focused on book recommendations, mental health, local bookstores, and travel, and has over 10,000 dedicated followers over several social media outlets. Leah lives on the South Side of Chicago with her book stacks and her cat Ms Nellie Bly. You can find her on Instagram at @whilereadingandwalking and on Twitter at @reading_while.

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