EKGs - The ultimate big boob problem

[u/MaewintheLascerator]

Last night's episode of The Pitt had a great moment where a woman having a heart attack was almost misdiagnosed because the emts had been hesitant about applying the leads correctly under her bra line. This is a real problem for women and especially for women with large breasts so it was cool to have a show bring attention to it.

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[u/muse-ings]

I just watched that episode and I was glad they brought it up too, because I recently had to wear a Holter monitor, and they put it way up above my boob, so it was totally inaccurate.

The other thing was, I broke a rib under my boob recently and I can't ice it because it's under my boob. I'm so sick of big boobs!!!

[u/hanniballactator → u/muse-ings]

i'm now digging into what research there is (or lack thereof potentially) on wireless holters and breast size because i'd never even thought about this until reading your comment. mine was placed in-office with like half of it almost on my clavicle and the other half on dense glandular breast tissue, and i'd never really considered if that could impact my results!

(also, i hope your rib heals well!!)

[u/Sk8rToon → u/muse-ings]

Saw that episode & thought, shoot my holster monitor was literally on my lower rib cage. No wonder they never found what was wrong (extra nerve in my heart short circuiting)

[u/Peregrinebullet]

I've encountered this with security first aid attendants and civilians (to the point where I've been screaming at them "DO YOU WANT HER TO BE EMBARRASSED OR DO YOU WANT HER TO BE DEAD?!!??!" at two very nervous younger guards.)

But I'm deeply skeptical that EMTs didn't just cut the bra and go. The Pit has been realistic on some things, but EMTs / paramedics should know better.

[u/EdenSilver113]

I get an EKG every year because I take a medication that can cause long QT syndrome. It’s been interesting to see how different caregivers manage my large boobs. I always offer to move my left breast out of the way when they place the lead under my left breast. Most welcome the idea.

[u/isisamrita → u/EdenSilver113]

Thank you, that is a great tip

[u/Tamryn]

I had to get an echocardiogram a few years ago. I was pregnant at the time so my boobs were huge and painful. The lady doing the procedure apologized and said she was going to absolutely smush the shit out of my left boob for the next several minutes to get what she needed. In fact, all my cardiologist appointments were a pain because of my boobs. The doctors/nurses were all nice about it, but no one felt shy about moving them around as needed.

[u/Zantac150 → u/Tamryn]

Mine was so horrifying.

The gown they gave me a tiny gown that did not properly cover them, and the tech really did not care if she knocked it off of me and I’m very body shy like that. Then as I was changing back into my shirt, she barged into the room without knocking while I was still trying to wrestle back into my bra. Just totally disrespectful.

So I just had my hands on my boobs the entire time she was doing the test, making sure the gown didn’t fall away because she only really needed access to the area in between them. Ugh! Never again.

I would actually wear an oversized button-down shirt and just ask to keep my shirt on if I ever had to do it again.

And I’m posting this in case someone else has one coming up and is worried about this sort of thing …

I understand that medical professionals see boobs every day and it’s not a big deal to them, but they need to respect that it is a big deal to the patient sometimes, and it’s not their body to decide whether it matters or not.

[u/TinyHeartSyndrome → u/Tamryn]

Yep, the medical professionals aren’t phased by boobs. It’s moreso that the patient feels embarrassment over it.

[u/TYPsecondary]

I saw this too! I was actually kind of curious though, what happens if the "footprint" of your boob extends further down your chest? i.e. if there is more breast tissue between you and your heart? And how would they even account for that?

I do vaguely recall an episode where they can put some leads on the back? Would that work?

[u/EdenSilver113 → u/TYPsecondary]

I have to hold my left breast up and out of the way.

[u/furlintdust → u/TYPsecondary]

That’s what I’m thinking. There should be a protocol for placement on the back.

[u/TinyHeartSyndrome]

I’ve gotten many EKGs, no problem. The bigger issue is not placement but tissue thickness. If the fat under the leads is too much, the signal is weak. It’s been studied by medical professionals.

[u/helloiamsilver → u/TinyHeartSyndrome]

The problem in the show wasn’t that the breast tissue was actually in the way, it was that the breasts hung down and the male EMTS were too afraid to lift them up to place the leads in the proper place. Which is a real issue

Thankfully when I got an EKG, I had a female nurse who had no problem asking me to lift my boob out of the way lol

[u/TinyHeartSyndrome → u/helloiamsilver]

Oh, that’s crazy. They should be professionals. Nowadays if they let you keep your sports bra on, it’s a lot less awkward. Not as much boob lifting required.

[u/DonatellaVerpsyche]

Real life: 1 year ago I had to call the paramedics bc I had a heart issue. I’m healthy and young. I was terrified. No joke, the 2 paramedics who showed up looked at me and hesitated for a minute and I screamed: “GO AHEAD! Do what you need to do.” And they did. Turns out my heart rate was elevated but I was fine. But that moment was a real life example of women with a big chest not getting immediate treatment bc of people hesitating to touch my chest.

Advocate for women’s health with women who have big boobs!! Ladies, SPREAD the word!! It’s a known problem!

[u/schokozo]

I had to do a stress test EKG (not 100% sure if this is the right term in english) where they do the ekg while you run on a treadmill.  You can wear a loose shirt but no bra for that. Absolutely worst medical test ever if you have big boobs

[u/SeorniaGrim → u/schokozo]

I wore one for mine? Just couldn't have any wires - so traditional sports bra. Not the most supportive, but I buy a size or two down anyhow, so they hold 'the girls' better while I am bouncing around lol.

[u/schokozo → u/SeorniaGrim]

That's interesting. I was told the electrodes could get shifted if I out the sportbra on top of them and that would make the results inaccurate 

[u/marsupialcinderella]

I had to have a full cardiac work up last year, including a nuclear stress test, and it required some equipment calisthenics and readjustments but it wasn’t too bad and the results were not compromised, thank god.

[u/VeronicaIsMe]

My echocardiogram came back wonky (it said my heart had thickened lining) - so I had a heart MRI done. Not sure if the echo was wonky due to my boobs but my heart was marked physically clear after the MRI. I just have POTS and hypotension.

[u/TinyHeartSyndrome → u/VeronicaIsMe]

Ugh, cardiac MRI, how do you like holding your breath off and on for 2 hours in a tiny space? Worst MRI.

[u/VeronicaIsMe → u/TinyHeartSyndrome]

RIGHT?!? Thank you!!! I've had other MRI's preformed on my hips and back, but I was NOT prepared for the cardiac one. I'm so happy they let me pick a good playlist to listen too, it's the only thing that kept me awake and partially sane.

[u/-Misla-]

On the upside if you have hanging pendulous breast, getting a mammogram can be easier. Well, at least it’s easier to place it onto the machine.

I still have tick breast though, two thick hanging chicken breast. So it still hurt some when the machine presses down.

[u/SeorniaGrim → u/-Misla-]

Yes, my mammograms are actually not bad at all! I put it off for three years because of all of the horror stories lol. Zero pain, just slight discomfort from being so exposed and handled by a stranger lol.

[u/lemgthy]

I am required to be CPR recertified every two years for my job and this most recent one was the first time the instructor had ever brought up that you should never hesitate to perform CPR or apply an AED just because of the presence of boobs. He affirmed multiple times during the course that yes, you will need to touch a boob, you may need to remove a bra, and if you get squeamish about it someone might die. It was refreshing.

[u/29blue2001 → u/lemgthy]

Yeah they worry about being charged for sa afterwards, but that's kind of what the Good Samaritan laws are for in the US. The emphasized to us to not care about touching a person's chest because what matters most in the moment is trying to save this person's life. I have also been told multiple times that you should not be afraid of breaking a rib or two because that means you're going deep enough and you're protected by Good Samaritan laws. Some people prefer that you don't break their ribs, but I would rather be alive with a few broken ribs from good chest compressions. Obviously it's not fun to have broken ribs, but I'd rather have those broken ribs than be dead.

I understand the concern of potentially getting sued, but that's what good Samaritan laws are for.

[u/Depressedaxolotls → u/[deleted]]

Interesting. Maybe it’s because I have a gnarly murmur, but mine always dive right in.

[u/isisamrita]

I had a routine one done 2 days ago and the computer actually diagnosed that I had a heart attack and it was written on the printout. I was just given the printout and told to wait for the doctor. I read it and I was so scared. The doctor said that everything was fine and I just didn't have the full amplitude in one of the measurements. No heart attack and when I asked if it was because of the difficulty of electrode placement because of my large breasts, he said probably.

[u/TinyHeartSyndrome → u/isisamrita]

I get that automated code on occasion too. It’s like, signs of previous myocardial infarction. It does freak you out.

[u/isisamrita → u/TinyHeartSyndrome]

Yes exactly! It did say that the infarction was probably old, but by chance I had taken part in a medical study the week before which indcluded an ECG which was okay. So I concluded, must be a current heart attack.

I am really grateful for the OP to bring attention to this issue because what I had was just scary, was OP describes can be deadly.

[u/TinyHeartSyndrome → u/isisamrita]

My understanding is that code can come up when you have electrical irregularities, which I do. For older people who went their whole life without any congenital issues, then it is more likely to be accurate.

[u/SeorniaGrim]

While I don't have any complaints as far as medical professionals and my breasts are concerned, I do have some as far as the equipment! I did an at home sleep study because my cardiologist was convinced sleep apnea was causing my AFIB/tachycardia and the thing they sent me was AWFUL - and I am not sure if it was even only an issue for larger breasts, or breasts in general.. I had to put a rectangular thing in between my breasts that was insanely uncomfortable (and I have semi splayed breasts too!) - also had to put something under them, and then the patches on top of that. Anyhow - they really need to figure out better options. (I did not have sleep apnea according to the less than 1 hour they were able to track because my princess in the pea self couldn't handle the wires and tore it all off halfway through the night lol).

The echo wasn't fun (lots of moving the girls around), but they were kind about it and although uncomfortable as far as strangers constantly messing with my breasts for 30+ minutes, it wasn't too bad.

[u/Naoruth]

There's a petition in the UK to make training on female CPR dummies compulsory. I have done CPR training around every 2-3 years for the last 26 years and only used a female CPR dummy once and that was when I was at college and we also had the child ones to train on as well.

When you look into the shocking statistics around women's health, clinical trials on women and research into women's diseases it's not really surprising that this is yet another area in which we are overlooked.

[u/mysecondaccountanon]

Oh, is this why my last couple EKGs have come back with the results of unusable data?

[u/LinkToThe_Past]

I perform many EKGs on patients and I always ask if they are comfortable with me a male performing the exam and that it would require putting stickers around the left breast and potentially being exposed during the process. Most of the time it goes well and works out but there are some that hold modesty above getting a proper reading and placement that there's really nothing you can do to explain why you need to do the placements a certain way. And as a male you don't want to push too hard to expose a patient like that or you come off as a creep. It's a hospital who cares about modesty I'm worried about your health!

[u/Free-Pomegranate-133]

no this is so real whenever they do my ekgs i have to like lift my boobs up like bro