Heart Disease: Symptoms and Prevention
Two Real-Life Experiences
When Sue Bullers began to feel ill on October 22, 2002, she wasn't overly worried. Her shoulder ached, and she felt nauseated and exhausted, so the 39-year-old single mom from Grinnell, Iowa, went to bed early, figuring she'd feel better after a good night's sleep. When she woke up in the middle of the night with a feeling of heaviness in her chest, she wrote it off as one of her usual bouts of heartburn. But the next morning, she vomited and felt dizzy. She called her doctor, and a nurse advised her that if she was feeling "really bad," she should go to the emergency room.
That sounded extreme to Bullers, who at this point thought she might have gotten the flu, so she decided just to stay home from her job as an instructor at a group home for mentally impaired adults. A few hours later, as she was making a sandwich for her 4-year-old daughter, Taylor, she felt dizzy again and suddenly passed out on the floor. Taylor threw herself on top of her mother and started slapping her face, screaming, "Wake up, Mommy!" That almost certainly saved Bullers' life, since she revived enough to crawl to the phone and call for help.
At the hospital, doctors discovered that the young woman was having a heart attack. "I was terrified and thought, 'Oh my God, I'm going to die,'" says Bullers, who turned out to have 99 percent blockage of her right coronary artery. She was catheterized and treated with a stent -- a tiny mesh tube threaded up through a vein in the leg and used to open a clogged vessel -- plus several medications, including a beta blocker (which blocks the effects of adrenaline on the heart) and an ACE inhibitor (which lowers blood pressure, thereby reducing the heart's workload). She was in the hospital nine days. (Her parents took care of Taylor.)
She recovered with only minimal damage to her heart and is now back at work, yet Bullers is still shocked -- and scared. Although she had several risk factors, including smoking, type 2 diabetes, and being overweight, she just wasn't aware what a dangerous combination they were. "I never thought I'd have a heart attack at 39!" she says.
That thought had never occurred to Andrea Lachowyn, 42, either. But when she got home from work on September 6, 2002, she suddenly felt so profoundly exhausted that she had to lie down. At the same time, the sales manager from Dublin, Ohio, started having severe pain in her arm, chest, and back. She thought she might be having a reaction to a prescription medication and was frightened enough to call 911.
When paramedics arrived, however, they didn't seem to take her symptoms seriously. "I got the impression that they thought it was just anxiety," says Lachowyn, a divorced mother of three children ages 5 to 15. "They didn't even take my blood pressure right away." Still, the paramedics took her to the emergency room, where she was given an electrocardiogram (EKG) and told that her heart function looked fine. Four hours later, she was sent home with a prescription for Valium.
Lachowyn slept for a few hours, but the next day her pain was even worse. She called a neighbor who was a doctor, and he examined her at his home office. Her blood pressure was very high, so he drove her to an urgent care center, where doctors dispatched her to the same ER she'd been to the night before. By now Lachowyn was in such agony she could barely move, so she was given a shot of morphine. Her father, who had made it to the hospital to be with her, didn't think that was enough. "Did you check her heart?" he demanded. That prompted doctors to do a blood test to check her level of cardiac enzymes (an EKG alone can miss 60 percent of heart attacks). The test revealed that Lachowyn, a former 15-cigarette-a-day smoker who worked long, stressful hours as an automobile sales manager, had suffered a heart attack the day before. "I couldn't believe it," she says. "And I was angry that my symptoms had been ignored. If I were a man, I wouldn't have been sent home with Valium."
Lachowyn was treated two days later with balloon angioplasty (insertion of a balloon-tipped catheter) to reopen an artery that was about 50 percent blocked, plus several medications, including aspirin and beta blockers, which reduce stress on the heart. She was lucky: Her doctor says she suffered very little heart-muscle damage. She was back at work in about a month, but ever since, instead of working 65 or more hours a week, she has cut back to about 45.