The title of this thread asks the question, ''When is it ok to ignore "Life threatening" symptoms''? The simple answer to the question is... its never OK.
As many doctors will tell you as a person living with ME or CFS the irritating punch line in ER if you attend with chest pain/shortness of breath is, ''don't worry about it, it's probably just a panic attack''. I'll focus on this problematic conclusion of physician based symptom assessment and how people can be incorrectly told they don't have a potential life threatening disorder and even told to go home and not come back, because of the stigmatised disease label they have.
Firstly, life threatening disorder is open to conjecture and should really be split into groups of presently or possibly. For example, the classic panic attack and rapid heart rate that comes with it, is a horrible symptom to experience at the best of times. For a healthy person, a panic attack will not hurt you. This is true.
So a tachycardia of a sinus rhythm is not life threatening and will appear 'normal' on an ECG, but it may be life threatening if you become dangerously hypertensive (high blood pressure) and have a stroke due to having dysautonomia and you are your doctor aren't aware of this. Additionally, if one has Asthma or anything that weakens the heart (ironically, ME and CFS), then having a sustained tachycardia can result in de-compensation, a situation where your heart does not fill correctly and your circulation becomes compromised. In someone very weak, this can have undesirable consequences if the tachycardia is not brought under control, sinus rhythm or not. Those are existing conditions, but the danger to worry about is also....
New onset conditions we don't know we have. These can also be dangerous and fobbed off as anxiety based. Yet anxiety and resulting panic can be and often are symptoms of serious underlying physical problems with the body (Low glucose, deranged electrolytes, hypoxia, infection etc). The additional danger here, is when we become very sick, our judgement can become clouded. We actually tend not to panic, but become listless and indifferent to our predicament.
It seems a universal problem, is doctors don't like telling people medical 'facts' who haven't been assessed for a variance of potential reasons for the new-onset symptoms (presenting as over anxious 'worried well'), as doctors can fear patients may return for more and more tests and continuing pestering them. If a doctor is biased due to ME or CFS discrimination, they will believe that the 'mental health problem of CFS', is potentially made worse by sending patients for more tests, so they consequently won't admit you to hospital or refer you in ER situations that are unclear if there is an underlying physical cause. One needs to be aware of this, in my view, as a patient and learn to stand your ground whenever possible. This can be done respectfully and calmly, but it often requires a lot of support, such as from your partner/carer/parents etc.
I believe in the UK NHS system of health care provision, doctors working in GP surgeries are paid incentives to reduce referrals to hospitals to have tests performed to reduce to costs to the state. It is thus financially rewarding for a GP practice in the UK not to refer the alleged 'anxious' patient. (This is the reverse of private health care insurance systems that want to give you every test under the sun to increase the costs...to the patient).
If I was a person with ME, CFS or even healthy, I would never ignore what you perceive to be a life threatening symptom until a medical profession has proven to you, what you're experiencing isn't. Even if they can do this, this does not preclude your ability to develop life threatening symptoms at a later date.
If in doubt, always go to the ER or call for an ambulance if you develop sudden distressing symptoms and/or a progressive worsening of disabling symptoms you don't usually experience. NB: The most active sports-persons can succumb to pneumonia because they 'thought it would get better'. The same goes for sudden onset chest pain, breathing difficulty and/weakness in a limb/slurred speech etc. ME and CFS sufferers are not immune to 'normal' health emergencies, although we can be slowly brain washed into believing this, as we are well used to staying tucked away at home receiving no medical care for our chronic health conditions that often far exceed any 'criteria' list used to initially diagnose us.
One needs to consider this fact, that for a significant percentage, ME or CFS is progressive. We get worse over time, and we develop health conditions we put down ourselves to 'just ME CFS', when these can actually be heart failure, cancers, arthritis, diabetes, kidney disease etc).
As patients, we are in a very vulnerable position with a diagnosis of ME or CFS, and I would certainly trust your own judgement and do not feel fearful of being humiliated in ER by a disbelieving doctor and avoid attending a hospital for reassurance and diagnosis. It's best to be a bit embarrassed and be sent home, that never to arrive in ER at all due to being in heaven.
Speaking from personal experience many of ME or CFS 'emergency' symptoms can be due to a deranged autonomic nervous system. This does indeed initially present as 'anxiety' (if one then becomes scared), but the underlying causes are not within conscious control and with correct testing, it then becomes obvious patients are a lot more than just 'nervous'.
Unfortunately, the UK NICE guidelines advise against a TILT test to detect,and diagnosed dysautonomia in ME or CFS patients, making sufferers bounce in and out of ER, often experiencing horrible things that make us more worried, more jaded, and more scared to go to hospital when we become acutely unwell. Long term, this is psychologically, as well as physically damaging (if symptoms are not reported to medical professionals).
Sadly, this is a consequence of psychiatry owning ME and CFS, due to non test based 'fatigue' based research.Since the late 1980's, doctors are still not trained in realizing how ill we are, and that we often can suffer from very nasty complications due to having ME or CFS.
Trust your instinct and remember we only have one life and once chance on this planet to experience life. Doctors are paid to diagnose and if necessary, treat you. It's their job, so they can do it for us too, even if we have a disbelieved label that makes us cautious on getting opinions on often very distressing symptoms.
