August 8th is Heart Attack Awareness Day.
It's not officially sanctioned or even observed anywhere in the world other than at my house. On the two year anniversary of the day that I discovered firsthand what a heart attack feels like, I thought I might share a thing or two with anyone interested in reading past this paragraph.
Hearing an emergency room doctor tell me that I was having a heart attack was the most surreal moment of my life. 43 year old cyclists don't have heart attacks! How could this be happening to someone who exercised regularly, wasn't overweight, never smoked, and rarely drank (not even coffee)?
The winning answer, at least as far as the ER doc was concerned, was my mother's family history of heart disease. Not to seem disrespectful, but there wasn't a male who made it past 60 and her younger sister appeared to be setting a record for stent installation. Mom herself was suffering from congestive heart failure at 75.
As the special triage team wheeled me into the catheter lab, I didn't have much time to ponder the bad hand genetics had supposedly dealt me. The cardiologist was too busy lecturing me about failing to recognize the heart attack signs and waiting too long to seek medical assistance.
Dismissing chest pressure as indigestion and left arm pain as poor circulation from sleeping on it the wrong way proved to be a near fatal misinterpretation. Flying home from California and arriving at the ER 14 hours after the symptoms began was borderline suicidal.
Recognizing the Signs of a Heart Attack
Television and movies have lied to us. Not everyone grasps their chest and calls out "Elizabeth, I'm comin' to join ya honey" like Fred on Sanford and Son. What Hollywood calls a heart attack is technically cardiac arrest.
Myocardial infarction - the technical term for heart attack - can have varying symptoms including constant or intermittent chest pressure, left or right arm pain, stomach, neck, jaw, or back pain, shortness of breath, lightheadedness, nausea, or breaking into a cold sweat. Left untreated, it can develop into cardiac arrest.
Confusing chest pain - an intense pressure in the center of the chest - for indigestion or congestion is a common mistake. Expecting the full complement of symptoms to confirm your worst fear is the mistake I made. Any single, additional symptom should trigger an alarm bell and a call to 911.
Survival Rates and Residual Damage
When I arrived at the ER 14 hours after my symptoms began, the cardiologist hoped it wasn't too late to help me.
Every second matters during a heart attack. The more time that elapses before treatment begins, the more permanent damage occurs to heart muscle. The likelihood of going into full cardiac arrest also increases as treatment is delayed.
Statistics show that the quicker one arrives for treatment, the greater the chances of survival. ER rooms are experienced in quickly and accurately diagnosing heart attacks. Triage teams and catheter labs make it possible for blockages to be cleared without the need for by-pass surgery, depending on the severity and nature of the artery blockage.
I was lucky.
Despite blockages in the "widow maker" artery of 90 and 100%, the on-call cardiologist was able to clear them with an angioplasty and two stents. A third blockage of 90% in the circumflex artery would have to wait another five weeks for a second angioplasty and stent installation.
Two days after my heart attack, an ultrasound technician performed an echocardiogram to determine the damage done to my heart. My ejection fraction - the percentage of blood pumped from the left ventricle with each contraction - was measured. A normal fraction is between 55 and 70. Mine was 42.
Recognizing the signs of a heart attack and seeking medical attention immediately can save your life and lessen the amount of permanent damage to your heart.
Recapping my story with my older brother mere days before he suffered his first heart attack resulted in a quicker visit to the ER and less damage to his heart. A female friend of the family, on the other hand, had a very difficult time recognizing the symptoms (this is very common with women as the signs aren't as pronounced), waited too long to receive treatment, and now has a defibrillator in her chest to treat her sub-30 ejection fraction.
Every medical staffer I have shared my story with is amazed that I survived. While I credit my strong heart (prior to the attack, that is) to nine years of bicycling, I was still very fortunate that my heart could withstand a 14-hour attack without sustaining more damage or entering cardiac arrest.
As I entered cardiac rehabilitation two weeks after my second catheter procedure, I was determined to reclaim my fitness and improve my ejection fraction. It would take another 12 weeks of progressive workouts and continual research before I determined what actually caused my heart attack.
I'll share that in future posts...