Personal note

This week’s article is a repeat of an article I do every year in February, National Heart Month.

Over the past few years, I have done countless presentations of my talk, now called “The Angina Monologue,”   during which I have not only delivered life-saving information, but I have listened, too, and gotten important information from my audiences.

If you’ve read it before, read again, and remember always to pay attention to the organ that the ancients believed was the seat of consciousness, and which we know as the center of our lives.

Be Careful, It’s Your Heart: Warning Signs of a Heart Attack

February is National Heart Month, and I have been more than ordinarily busy giving my talk, “The Angina Monologue,” in which I describe women’s heart attacks and give preventive advice.  Seeing all the “red” clothing and decorations, hearing of all the “Wear Red” events is exciting – except that cardiac disease occurs all year long, not just in February.

In fact, cardiac disease is the #1 killer of both men and women in the United States; but while the rates for men are declining, the rates for women, particularly in the age 35-54 age group, are rising.

We are surrounded by information about cardiac disease in newspapers, magazines, on the radio and on television, yet most people remain surprisingly ignorant about some of the simple facts of cardiac disease.  So I am once again providing a fuller description of the symptoms, as experienced by real people I have known, including myself.

The “Hollywood Heart Attack,” where the character, clutching his chest, slumps to the floor immediately, does sometimes happen.  But many heart attacks do not mimic this model.  In particular, women’s symptoms of heart attack may be very different from men’s in both quality and severity.

(Note:  since first writing this article, I have heard from  some audience members that their husbands also displayed these subtle symptoms, and never progressed to the more typical male symptoms.  Luckily, they paid attention and got help. But, I do think that women are more likely to have these subtle symptoms. No one should overlook them, however.)

It can be too easy to brush these more subtle symptoms aside; as one woman in my cardiac support group said, “Compared to childbirth, this is nothing!”  But of course, they are something.  And the sooner you pay attention and get help, the better the outcome.

Because I paid attention to a small signal, and took action immediately, I have almost no heart damage and was able to return to a full life immediately.

So I’m going to provide some descriptions here that might give women a clearer picture of what to look for.

Chest discomfort:

Men typically experience crushing chest pain and pain radiating down one arm.  Some women do also, but many women do not. I only experienced one second of pressure in the middle of my chest, accompanied by a complete lack of breath – once again for one second only.  Luckily, I paid attention.

Another woman I know reports that she felt as if her chest were on fire.

Any pressure, squeezing or burning in the center of the chest that lasts for more than a few minutes or comes and goes is a warning sign.

Upper body discomfort in one or both arms, back, neck, jaw or stomach:

One woman I knew had pain in her jaw; another was awakened in the middle of the night by very painful elbows, which she fortunately recognized as being related to her heart.  Others tell of pain in the neck, the shoulder or across the shoulder blades.

At a talk I gave recently, a woman told me of a pain in her jaw.  She had been checked for both a dental problem and a tempero-mandibular joint problem, but no evidence of either had been found.  Should she see a cardiologist, she asked?  I almost shouted, “Yes!”

Any pain in the upper body that can’t be explained should be suspect and you should take action.  See a cardiologist; if the pain is marked or persistent, dial 9-1-1 and go to the ER.

Shortness of breath, with or without chest discomfort:

Once again, when there is no rational explanation, such as allergy problems or just having run up a flight of stairs, you should be suspicious of shortness of breath.

Dizziness, lightheadedness or fainting, nausea and vomiting, cold sweats:

I began to experience nausea and lightheadedness a few days after my experience with pressure (I had already seen a doctor, who found nothing wrong with me). It could have been a virus, but I had no temperature. Taking your temperature is a good idea before you decide it is a virus and dismiss the idea of a heart attack.

After I got to the hospital, I began to experience severe gastric distress, a little like the commercials for acid reflux disease, with figurative nuts and bolts revolving around in my stomach!  A doctor asked me, in fact, if I did have acid reflex disease, and when I said no, it was another factor on which they decided to do angioplasty (go in and see if there was blockage).

I know of a young woman athlete who began to faint after she finished races.  She, in fact, had an undiagnosed congenital defect of a heart valve for which she needed surgery.

So, once again, if there isn’t a good explanation for the symptom, seek help.

Feelings of anxiety, fatigue or weakness — unexplained or on exertion:

I have met at least one woman heart patient who tells of being overwhelmed by inexplicable anxiety as her major symptom. Once again, there was no precipitating event in her life, so it was a very suspicious episode.

The extreme fatigue that a heart attack sufferer experiences is like having a hole in your “fuel tank” from which all the energy has drained out.  One woman I know told me that she was so tired she lay down on her bed, and, feeling cold, wanted to pull the covers up but she couldn’t because it was too much effort.  That was when she realized she needed to get to a hospital.

Take Action

There is an e-mail that keeps circulating on the internet, with advice about heart attacks.  Some of it is good advice: carry an aspirin and take it immediately if you believe you are having a heart attack.  In fact, crunch down on it and wash it down with a full glass of water.

But this e-mail always ends with dangerous advice: “Call and friend or relative and wait by the door,” presumably to have that person take you to the hospital.

This is the message health care providers want you to hear: Do not drive yourself or ask a friend or family member to drive you.

If you have any of the above symptoms, dial 9-1-1.  If you are having a heart attack, emergency responders can start treatment in the ambulance. This can be crucial.

Women, who are often reluctant to have a fuss made about themselves, will dial 9-1-1 in a minute if a loved one is threatened, but will not do so for themselves.

Those few minutes in which you wait for help can make all the difference in the world between life and death, or between a quality life and an impaired life.  One of the possible consequences of heart attack is loss of oxygen to the brain, causing irreversible damage.  You could survive, but only as someone very dependent on others.

The last message I like to leave women with is this:  strive to live the heart-healthy life, and you will feel better than you have in years.  Would you like to wake up every morning eager to start the day, with the kind of zest you had as a child? You can do it!  The women in my support group, cardiac survivors all, glow with health.

The path to  is the path to joy.  And who doesn’t want joy?