Matt, I've been reading this since you posted it. Poems about health, heart disease, are tough. I've written a couple about my CHF but don't like them very much. I like this one because it is angled in a way that toys with the topic until it's ambivalent. (Now, I'm wondering if it is about heart disease. It could be about love.) That is good.
My one quibble is the "golden throne." It is too obvious, generic. It's a place in the poem you could be more interesting and as slyly revealing as the rest of the poem. If you do that the "ersatz throne" can be cut as well.
These are my suggestions. I hope they are of some use.
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