On a recent overnight shift in the emergency room, a woman who was having vague abdominal pain and chest discomfort for several days was referred to me. When her symptoms began, after searching google, she came up with a diagnosis list that included everything from influenza, to Zika, to lupus. She came to the hospital several days later when it became hard to breath and it turned out that she had a massive heart attack.
Cardiac pain originates from the heart muscle, most typically when blood flow to the heart (through vessels called coronary arteries) become blocked. In the heart muscle, there are nerve endings which transmit signals to the brain which get interpreted as chest pain. Unfortunately, just like other pain arising in other organs in the body, cardiac pain is poorly localized. Think of when you had stomach cramps after eating some food you probably shouldn't have--the pain is often vague and generalized, as opposed to being isolated to one specific location. Furthermore sensations arising from other organs in the chest, such as the esophagus, can produce pain indistinguishable from cardiac pain.Adding to this ambiguity is depending on your sex, race, and other factors, your description of pain may be significantly different than someone else. Topping it off, different healthcare professionals may also interpret your description of pain very differently. To help cut through the mountain of linguistic ambiguity, studies are now being done using artificial intelligence (AI) to help decode our description of symptoms to provide more accurate diagnoses.
At the recent American College of Cardiology meeting, I had a chance to discuss some of the developments in medical AI with Dr. Catherine Kreatsoulas, a Fulbright Scholar working at Harvard University. Dr. Kreatsoulas's research focuses on gender differences in cardiovascular disease and symptom differences between men and women.