Don’t Wait For Cymbals and Fireworks!

This won’t be about books or travel adventures or horses or dogs, but it’s important information for everyone. 

In the movies, you know a character is having a heart attack when he staggers and clutches his chest. If he’s standing, he falls to the floor; if seated, he slumps forward onto his desk. And I’m saying “he” because I don’t recall ever seeing a female character in a movie have a heart attack, though real women do.

My question is, how do you know when a real person is having a heart attack? The first thing you need to realize is that it might not be at all dramatic. Take a look at this list of symptoms of non-ST segment elevation heart attack:

Chest pain or a feeling of pressure in the chest.

Discomfort in the upper back or in the area between the shoulder blades.

Upper back pain.

Tingling in the hands and arms.

Shortness of breath.

Heartburn or indigestion.

Sudden cold sweats.

Unexplained sweating.

Sudden lightheadedness.

Unexplained feelings of nervousness or anxiety.

Feeling of tiredness, or not feeling well.

The symptoms in boldface are the ones my husband had for two days before we went to the ER. He blamed the altitude here in SE Arizona on the shortness of breath and tiredness, and he thought maybe had strained some muscles (chest and back) somehow, though he couldn’t think how. He never had what he called pain. But the “not feeling well” persisted, and that’s what finally sent us to the hospital. 

At the ER, blood tests showed cardiac enzymes in the blood. “You’re having a heart attack,” the doctor told him, saying also that “because you waited so long to come in,” they couldn’t do more to treat him in Willcox and he would have to be flown by helicopter to Tucson.

Everything is okay. He spent two nights in Tucson Medical Center, was stabilized, and finally released to return home, with new medications and follow-up visits scheduled with various care providers. I’m posting this so everyone who reads it will realize that a heart attack may be very subtle.

No one wants to have a heart attack, any more than anyone wants other life-threatening events or diseases, and it’s tempting to look for ways to explain away the symptoms — “I’m just tired,” “I must have sprained a muscle,” “I’m not used to this altitude,” or whatever applies in your particular case — but if you or someone you know is having these symptoms, pay attention!

“There are so many ways a heart attack can present itself, and only the classic one is stored in people’s minds.” 

That’s what one friend wrote to me in an e-mail when she got the news, and that’s when I decided I needed to share what we have learned with others. “The classic” is not the only presentation. Others are less dramatic, much more subtle. Don’t think “It can’t be a heart attack” just because there’s no sensation of being stabbed in the chest. 

Be well, stay well!

End of lecture.