Holiday Heart Attack

It’s the most wonderful time of the year.  And yet, 8 years ago this month, I suffered a heart attack. At age 43. And supposedly in the best health I’d ever been. I was very lucky. I'm doing fine, there was no permanent heart muscle damage, and I'm actually healthier than ever and feel great. But free of the commonly known risk factors, I find myself a member of a peculiar new sisterhood I'd never imagined I'd ever join.

 

Men Have Heart Attacks, Not Women, Right?


True, men are far more likely to have a heart attack, at least until a woman goes through menopause. Women between the ages of 25 and 55 are not free of heart disease concerns, however. We actually fall into what the American Heart Association calls their "silent epidemic." Not commonly known is that this group, supposedly free of heart disease concerns, is experiencing an ever-increasing rate of heart attack. Heart disease is the #1 killer of women in America. But even before going through our "change of life," heart disease kills twice the number of women than breast cancer.

 

One immediately envisions a heart attack patient as falling into the following stereotype. You know the one I mean. Someone with a big belly (this significantly increases one's risk), has liquid rivers of fat coursing through their veins, suffers from high blood pressure, is the poster child for a couch potato, is a chain smoker, and possibly even a diabetic.

 

Yet, here I am. I'm young (certainly I think of my early 40s as youthful), not overweight, never been a smoker, have no issues with cholesterol or triglycerides (in fact one doctor once told me I should try to consume some fat in my diet to help balance my nonexistent blood fat levels), no history of diabetes, have incredibly low blood pressure, and am somewhat active (there's certainly always room for improvement).

 

So what's wrong with this picture? The plot thickens. A host of less likely risk factors can take an apparently healthy woman and place her smack dab in the middle of cardiac rehab. The factors going against me:

 

Stress

You could take lessons from me on how to be the consummate type "A" personality. I'm the queen of keeping a million projects afloat at any given moment. Stress reduction classes and learning to say "no" loom in my future.

 

Menopause

I'm surgically post menopausal, but I thought HRT was my wild card to help prevent the risk of heart disease in addition to reducing bone loss, early menopausal skin changes, and of course, keep hot flashes and the like at bay. Wrong.

 

Genetics

My mother had her first heart attack at the age of 57. Family heart attacks below the age of 55 are considered a risk factor but she'd been a lifelong smoker, is fairly sedentary and a touch plump. So I hadn't really taken this "to heart" as a serious health risk. Since then, my brother and father have gone on to have heart disease. Family history established, but a tad too late for me.

 

Past Medical History of Stroke

In my history I have a slight 24-hour version of a stroke called a TIA (transient ischemic attack) while I was pregnant due to a blood clotting disorder known as anticardiolipin antibody syndrome. As it turns out, the doctors this time around discovered a new genetic clotting disorder in addition to the original concern, which increases one's risk for forming blood clots up to 11 times than normal. It's called the Factor II, prothrombin G20210A mutation and believe it or not, it affects as much as 2% of the general U.S. population. And it is autosomal dominant which means you get it from a parent and potentially pass it onto your children. But most doctors have never heard of it. I hadn't, my doctor husband hadn't, and none of our doctor friends had ever heard of it either!

 

If you have a past history of multiple miscarriages, get screened for both of these clotting diseases in addition to Factor V Leiden. It turns out that pregnancy is not the only time to be concerned about these conditions. Fortunately, they are easily controlled with a variety of blood thinners.

 

A "Heartwarming" Experience

My heart attack occurred at the end of December. My family was readying for a holiday trip the following day. That morning I’d run over to the grocery to pick up a few last minute items. Suddenly, an overwhelming tube of burning sensation was radiating directly from my back forward into my mid-chest.

 

I knew women often experience "atypical pain" like jaw pain or nausea with a heart attack, but burning? I kept thinking all the NDSAIDs I'd popped the previous week for a cold were causing the discomfort. I continued shopping, clutching my chest, thinking this must be one awful case of heartburn ( an ulcer perhaps?). By the time I reach the dairy aisle, I was contemplating slurping some sour cream to cool things off. The pain probably only lasted a matter of minutes and once gone I continued onward with my errands. After all, women aren’t supposed to let a little pain get us down, right?

 

It wasn't until I developed left arm pain that I began to wonder if things weren't going quite as well as I'd thought. I got into the car, and thought, "Do I go to the hospital where they will surely admit me, I'll miss the trip, the hotel is non-refundable, I'll be fine, and my husband will be REALLY mad at me, or do I go home?" You guessed it, I drove home. By the time I reached my street however, the classic signs of a heart attack, crushing pain and shortness of breath, began.

 

Long story made shorter: I did make it to the hospital. I had a 100% block of one very small coronary artery. I had an angioplasty and a stent was placed. Things could have been worse. We were supposed to leave the next morning for a holiday vacation. I could have experienced this episode on the airplane or waited even longer to get myself to the hospital.

 

Immediately following my release from the hospital, I began cardiac rehab, which is essentially cross-training hooked up to an EKG machine. Other than the fact that everyone there seemed to be past patients of mine and that the 80 year old man on oxygen went faster on the treadmill than I did, things went pretty well! It took a good 9 months to get back to my original hectic lifestyle; I still appreciate the second chance I've been given.

 

Obviously I'm back at work. In fact, I'm literally living proof that you can not only survive, but thrive with heart disease. So what did I do wrong?

 

I should have gone to the hospital. Immediately. I should never have let the holidays, a vacation or anything else stand in my way. Remember your best chance for a full recovery is getting into a hospital cath lab for evaluation within 2 hours of the onset of the first symptoms. If you think you're having a heart attack, don't try to rationalize it away, like I tried to do. Take an aspirin if you have one (this helps prevent further blood clotting) and get yourself to a hospital or dial 9-1-1.

 

Heart disease is the number one killer of women. But it doesn't have to be. By learning more about heart disease, women can make a difference.

Added to Women's Health, Heart Health, Symptom Definition on Tue 12/21/2010