When to Worry
Many people experience chest pains, but when is a chest pain cause for real concern?
Heart disease is the number one killer among women, and two seemingly healthy sisters found out how serious it is just months apart.
Heart attacks can occur at any moment, and did for Kelly and her sister Kim. The day after taking a spin class and feeling fine, Kelly began feeling pain in her chest. Paramedics arrived at her house, hooked her up to an EKG machine and “they knew immediately I was having a heart attack,” Kelly says.
Seven months later, Kim woke up in the middle of the night, went to the bathroom and had tunnel vision and began seeing spots. “I couldn’t breathe,” Kim says. “I actually wrote a will on a napkin.
“When I first got to the emergency room, I heard the doctor saying, ‘She had a heart attack,’” Kim adds.
Kelly and Kim explain that they did have symptoms prior to having their heart attacks. Kelly felt chest pains while at the grocery store, while Kim had trouble breathing while doing the dishes. Because she did not have classic risk signs, such as high cholesterol or high blood pressure, Kelly’s doctor told her she was not a high-risk patient. “And then a month later, I had a heart attack,” she says.
During her angioplasty, doctors found that Kelly’s right coronary artery was bent in half, and when a catheter was inserted to straighten it, the artery ruptured. “If I hadn’t been in an operating room at the time, I probably wouldn’t have survived,” she says.
Kim was found to have a blood clot, which came as a surprise to her. “I eat well, I do yoga once a week, so I was shocked,” she says.
“I had classic women’s symptoms,” Kim adds. “No pain throughout the whole thing. I had unexplained shortness of breath, and during that week I had extreme fatigue and anxiety. When I was having the heart attack itself, I couldn’t breathe, [I had] vision problems, nausea. No pain involved whatsoever. It was terrifying!
“But I thought panic attacks were terrifying, too,” she continues. “So until I talked to my sister, and she verified my symptoms, I didn’t know I had a heart attack.”
If his patients question any symptoms, Dr. Travis advises them to see their doctor. “You don’t know if it is a panic attack or a heart attack,” he says. “And the symptoms for women are like you said. It could be chest pain; it could just be shortness of breath.
“If you’re a woman at home, you have to listen to your body,” he continues, “because if you don’t feel right, something could be going wrong.
“Everyone is at risk for a heart attack,” he adds. “Marathon runners can die of heart attacks. Anyone can die of a heart attack. The reason that it’s so important to go to the doctor, to go to the E.R. if you have any of these symptoms, is that for the heart muscle, time is muscle. If you get there within 30 minutes, we can almost always save your life. But if you sit at home for hours upon hours, your heart muscle will die. As your heart muscle dies, there’s a very good chance that you could die. And it’s preventable!”
Am I at Risk?
Cindy, 44, worries that she is at risk for a heart attack. She suffers from heart palpitations and shortness of breath and has a family history of high blood pressure. One of her sisters has already had two heart attacks.
Cindy has unhealthy eating and health habits, as well. “I’ve been overweight most of my life,” she says. “As time has gone on, I just have gone up, and up, and up and up in weight. I’m a stress eater; when I’m stressed I eat. I have healthy breakfasts with my kids, and they go to school and I’ll eat something unhealthy. I do eat the doughnuts, I do eat the cheeseburger. I just had a piece of pizza. I do eat the French fries.
“I don’t have a regular exercise program, and to be honest with you, I’m just lazy,” she continues. “It’s very emotional. Am I going to be here for my kids? I feel like my body is a ticking time bomb, and at any moment it can go off, and I might not be able to recover. I might not be here.”
The Doctors send Cindy to interventional cardiologist Dr. Lawrence Santora to have tests done on her heart. He puts Cindy on an EKG treadmill and performs a stress echocardiogram, which helps show any weakened heart muscles or leaky heart valves. “When she went on the stress test, it was perfectly normal,” Dr. Santora says. “The heart performed perfectly normal after exercise.”
Dr. Santora also performs an electron beam CT scan on Cindy, which picks up plaque in the coronary artery. “What concerns me about her, she has a very strong family history of heart disease,” he says. “She should really have this scan because most heart attacks occur when you have any plaque lining the artery and that plaque suddenly collapses into the opening. There’s no warning sign.”
Dr. Santora does not find any plaque or aneurysms in the sack around Cindy’s heart during the CT scan, although her right coronary artery is positioned at an unusual angle. He advises her to have a CT angiogram, during which he will inject dye into her vein and take a picture of her heart.
“But I think there’s a low probability of her having a problem if she gets her act together, gets her weight down and starts to exercise and eat right,” Dr. Santora says.
“The most important thing you can do, other than going to the doctor, is what you’re doing each day between those doctor’s visits,” Dr. Travis says. “It’s the lifestyle that makes a difference.”
Cindy says she is going to make the changes and live a healthier life so she can be around for her children!