Heart Attack hindsight - Warning signs you ignored

[milopesl]

I would be very interested in hearing your accounts of your personnal experience with heart attack. Primarily, the warning signs prior the event, which you might have ignored, or took lightly, but now with hindsight, after surviving the heart failure, would have acted differently. And then about the event and recovery.

Your experience can help the others.

I had an unpleasant experience of sudden weakness during exercise last month which may or may not be a symptom of heart problem. I described it in detail on Weight Loss forum.

Milo

[j1huegel]

Here it is first hand from a Heart Attack Survivor.

At the time, I was not a rower, but a runner. I logged 10-20 miles per week, some road, some trail. At 46yo, 5'8" and 199-200#, I was moderately overweight but quite fit CV-wise.

At the time, I had some difficulty with a couple of steep hills, but no real issues in the early fall of 2009 as a runner.

It happened when I was at a music (band) festival with my daughter in fall of 2009. My job as band dad was to feed the kids. I got the pizzas and other foods and was preparing to set them out for the 100 or so kids in the band while they attended the awards ceremony. I was alone on a hillside near the stadium.

Then an elephant stepped on my chest.

Being no stranger to athletic discomfort, I tried to walk it off. It was no use. I called my band parent buddy and he raced over the hill and found me panting and desperate. He called 911. 45 minutes later and after three "restarts" of my heart, I had stents inserted in my LAD artery. I can't tell you how lucky I was that an ambulance with EKG was 3 minutes from my location, and the hospital was 5 minutes away, with a Cath Lab and a specialist that knew his stuff.

So, for me, no overt warning signs. Except for the ones I did not monitor. After the fact, I discovered that my triglycerides were around 1500. Normal is around 100. Being an athlete, and in pretty good shape, I didn't think I needed the medical stuff. I was very wrong. I made my wife and daughter experience me "checking out" a couple of times during my ordeal and I'll not forgive myself for that.

Since then, I went on cholesterol and tri medicine. That helped a bit. But my Tri's continued to be very high. What I discovered was that my body is very sensitive to carbs; in fact I met most of the criteria for Metabolic Syndrome, a leading indicator of imminent heart, T2D and stroke.

In January 2012, I put myself on Atkins/low carb and hit the treadmill hard, and lost 50 lbs, and more importantly, dropped the triglycerides to under 100 and total cholesterol under my lowest ever. For me, the change to very low carb, high fat, caused measurable positive changes in both my body and my blood cholesterol.

Today, I am fitter and faster then ever. I can run faster than I did in my 20's. I am close to breaking 7:00 for the 2k after 8 months of training. I scare people with my diet but it works perfectly and it gives me endurance. I ran 20+ miles on water this summer "for fun", showered, and went on with my day. I can row HM's with no discomfort at around 1:28.

So milopesl, watch your cholesterol and BP. be sensitive to sudden performance changes and physical sensation changes. Know your lipids, especially LDL and Tri's. REALLY STUDY SPORTS NUTRITION. And, Like the billboard says, "When Heats Attack, Call 911. It's Never Nothing."

Interesting references: http://heartround2.blogspot.com is my recovery blog. http://eatingacademy.com will change how you look at nutrition.

[Ergmeister]

I too can give you a first account as a heart attack survivor.

In my case, I did not ignore the symptoms and signs and sought medical attention promptly, however, my actual heart attack came after I saw the cardiologist and after I had a stress test, but before I had a NUCLEAR stress test.

In a nutshell, I was skiing with my daughter in 2007 and she was with a friend and they were painfully slow. As a lifelong skier, I decided to do hot laps (singles line and top to bottom non-stop runs) until I caught up to them or effectively lapped them. On the 2nd lap as I reached the chair lift singles line, I felt a point in my chest that can only be described as if I had a sharpie marker pressing on my sternum; not the elephant on my chest and more like I had gotten whacked by something that "thorked" my chest. As I was leaning on my ski poles in the lift line and recovering from the higher heart rate, the discomfort evaporated and went away. Following that I skied easily down and in and sat out the rest of day a little spooked. The next day I was in the office of my internist first thing in the morning and he sent me to the cardiologist who conducted a stress test on a treadmill which I "passed" but it was inconclusive and a nuclear stress was scheduled for the following week.

Feeling confident that I did not have a heart attack, that weekend I resumed the rigors of physical work at my home which is also a horse farm. I go hard on the weekends and by Sunday night I was in bed lights out by 9:30. At 1:30AM I woke up from a sound sleep with the marker in the sternum feeling again. On a 1-10 of pain it was a 0.5. More an annoyance than pain really. Not taking any chances, I woke up my wife and she drove me to the hospital where they ran blood tests which revealed elevated heart enzyme levels suggesting trouble. The pain was constant but very acceptable. They gave nitroglycerine tablets and on the 2nd one, the pain totally evaporated.

Nitro is a vasodialator which relaxes the vascular system and enables increased blood flow and lower blood pressure. With a positive response from the nitro, I was put in a holding pattern and eventually the next day I went into a catherization lab (Brigham & Women's Shapiro Cardiovascular Center in Boston) and received one stent for a 99% blockage in one spot. Total success and I was at work two days later like nothing had happened. It was at that point, that I decided I better add more cardio to my life and took up rowing and erging and now do one or both every day.

I didn't ignore any signs and the lesson for all is that anything unusual in pain or twinges in the chest, back, arm, jaw, or teeth can all be signs of cardiovascular issues and need to be immediately eliminated by way of cardiologist and tests.

I was lucky that day. I have made many changes to my life since then; I'm now 100% plant based nutrition which is why I am a proponent of Forks over Knives; I exercise at least 60 minutes every day; and I see my cardiologist as regularly as he wants to see me. It's now been 6 full years since that first and only very mild heart attack.

One thing that I am keenly aware of is that statistically, I will have another heart attack. It's virtually guaranteed, however when that happens is solely in my hands with my management of food and exercise. I have reversed 100% of the damage from that heart attack and my cholesterol is 117; substantially below the 150 maximum target. LDL and HDL are both well below the range and I have removed many of the heart meds that I was placed on following that heart attack and only this past visit did I accomplish that.

Ignore nothing. Denial is what kills most people who suffer first heart attacks. Do not deny or refuse to believe it can possibly happen to you; it can happen to anyone. Blood chemistry is an indicator, but not a sole predictor. Family history is significant indicator of risk so know your family history for heart disease.

The people behind Forks over Knives are Cardiologists; they first connected the plant based diet benefits for nearly zero heart disease.

[Yankeerunner]

This is interesting reading, and something that concerns me more with each passing year.

As an endurance athlete since my late teens I, and most of my competitive peers, were smug about our assumed invulnerability to heart attacks. There were occasional heart attacks, but we always brushed them off as being anomalies due to bad genes or some such thing. In the past few years though what seems to be large numbers of my peers in their late 50s and early 60s have been dropping despite being thin, seriously active, and fast within their age group. Percentage-wise it probably is a small number (8 out of thousands), but since I knew all 8 personally it's troubling.

The sharpie on the chest (0.5 on a scale of 1-10) is disturbing. I deal with more discomfort than that throughout my body on a daily basis, and would likely think nothing of it. Thanks for the detailed case histories. I'd be interested in hearing from other survivors as well. We aging athletes in large numbers are a relatively new phenomena and it's good to try to keep learning as new things come to light.

[Cyclingman1]

My cardiologist practically snickers at me when I even suggest that exercise makes me immune from CV disease.

Even relatively low levels of LDL are insufficient if one has other issues like high calcification in coronary arteries. Most would have no idea if they have high calcification. I had a CAT scan a few years that showed my levels. In that case, one needs to have ultra-low LDL levels: < 70. Also he scoffs at the idea that high HDL protects. Exercise is obviously not without benefits, but it is only one factor in CV health and not even the most important.

[David Pomerantz]

Boy did you guys get my attention! I just started another thread. I've been life long into running and erging and am now 50. Basically I feel fine. I went to an optometrist 2 weeks ago and he incidentally measured my blood pressure. He wasn't phased at all by the number, but it got my attention! Since then I've been measuring it myself and I'm consistently about 140/90. I never thought it could happen to me. So now I'm looking at starting anti hypertensives. Apparently it is well established that controlling BP decreases risk of MI. Never thought it would happen to me. By the way, I'm a doctor.

Dave

[David Pomerantz]

Wow such an easy fix! I started the lowest dose of lisinopril, 5mg, and it brought my BP right under control. It was such a huge psychological barrier for me to admit I really had the problem. I took 2 weeks to get the medicine and another week to finally take the first pill. A few hours later my BP was good. Wish I could lower my erg times so easily!

Dave

[kayakr]

Is it a fix or a band aid that just allows you to keep hurting yourself convinced everything's fine now?
Like the NFL player injecting steroids.
Checked out "forks over knives" movie yet?

[DoctorJon]

With most hypertension it is a fix; well as good a fix as you can get. The majority of hypertension is of unknown cause, so called "essential hypertension". It is the raised BP itself that causes the damage over time to the walls of the blood vessels, reducing their elasticity and promoting atherosclerosis leading to increased risk of MI and strokes. Also can damage the kidneys which makes the BP worse. Get the BP down to normal levels, no excess damage - fix! You're on the meds for life and there are always side effects, but most get by untroubled.

Sometimes hypertension is secondary to other pathology, kidney or hormonal problems such as excess adrenal steroids (cortisol, not bodybuilder's steroids). In such cases the primary cause has to be identified and treated and anti-hypertensives alone would indeed be just poor sticking plaster. Actually, they often won't work in such circumstances of secondary hypertension.

As my user name suggests, I am a doctor and like Dr. David Pomerantz I never thought it would happen to me. But it did. And I am grateful for the existence of meds to counter the very damaging effects of hypertension, the silent killer.

[kayakr]

I'm glad your feeling good. Idiopathic, yeah, great we don't know why...

Still, folks over knives might be a great find to share with your patients.
I don't have metobolic symptoms of any kind but going veggie reversed progression of my toe arthritis (hallux limitus) and was way better that 500 mg Napron Sodium after only 1 week.
My dad had angina (going up 1 set of stairs!) in his forties but cured himself eating truly low fat.
He programmed until he was 70, when his friends that under went the cuts had already dropped away.
Anyway, perhaps this cookie here will be useful to someone in the future when they are ready.
The truth is out there but sometimes it's so hard to see sometime. Trust me on that, i know.
peace be with you.

[smutav]

At 42 and fighting fit, no smoking history, very very light drinker, good nutrition (never had a maccas!), normal BP 110/70, good LDL anf Tg, good HDL and low cholesterol , i experienced the first of 2 hrt attacks. This was a total LAD (the widow maker) occlusion. I presented with at first mild chest pain right above the heart, more a discomfort that at 42 and fit i put down to pushing myself too hard when exercising. I visited the GP who did an examination and gave me script for bloods, xray and ecg. On the way from her office i experienced bad chest pain but still had the tests done. I went home and spent a miserable night in discomfort. I thought the tests wouldve shown something at the time....and they did but this wasnt reported til the next day by which time i admitted myself to ED to be told i was going into the catheter lab immediately. I had a major heart attack, the one that would usually kill but survived due to fitness and ....stubborness
I spent the next 10 years trying my best to do the 'right thing' until my second attack,at 52, this time a 95% circumflex blockage.
My cardiologist tells me to keep up the exercise, eat well and take my meds......i told him 'this is what ive been doing for the last decade !!". He had no answer. The system doesnt cater for people like me.
Clearly there are anomaly patients like me for whom we have no real medical answer yet.
Ive researched a lot since and come up with things like endothelial dysfunction, inflammation, Paulings theory, arginine supplements, nitric oxide synthase, resverotrol, omega 3, vit A C D E, linoleic acid, low fat diets, high protein diets, low carb diets, elevated homocysteine, cRP, IL 6 etc......all manner of ideas..
the Q is, which one do i believe?
i havent got time to experiment....there is only one guinea pig.
Clearly the mainstream medical world does not have an answer for me or others like. Cholesterol is not the crux of CVD- i am tired of hearing about it from every medico i see- all like sheep following the same story without ever having researched it themselves.
i see myself as having to do this myself, with a medical background i can research but the more you read the more confusing this CVD nightmare is.
ive taken to the rower for mild, regulated and controlled exercise.........the one thing i can rely on.

There must be thousands in my shoes.....most of them silently and ignorantly following the orders of a medical profession that doesnt really know !

[basilgirl]

This is all good reading. A friend of mine died recently, 44, fit, regular runner, non smoker, light drinker. He'd been for a run, felt a bit dizzy then collapsed and died instantly.
It turns out though that only 2% of his blood was getting through to his heart and I'm amazed this didn't cause any symptoms beforehand.
I read somewhere recently that if you're alone and experiencing a he4art attack, keep making yourself cough. Has anyone else heard of this?

[smutav]

well, thats the great thing about such forums, we can all share our experience and knowledge...in a civilised way.
We just had a community fun run here (12 and 23 kms) and two guys died immediately after.... of heart attacks...despite medical assistance at the line. One was 32, the other 52 yo. No prior heart issues, just keeled over and died post race these 2 incidents taking the tally to 3 people in the last 2 years of this event. People who had trained and had felt quite well and capable into and during the race. this is the essence of my original post which met such great obstinacy.
People tend to work their bodies til they fatigue predominately the fatigue of skeletal muscle, the expectation being that the heart muscle will just do what is required to do as we push ourselves. These are two very different muscle types. Obviously if skeletal muscle gives then no problem,we just collapse exhausted, rest and then get up again but if the heart muscle gives, then BIG problems, potentially even death. That is why i urge people to not just go for broke but to administer some science to what they are doing exercise wise ie maxHR for example to get a grip on how far they can push not so much their bodies ie skeletal muscle and respiratory , but more so their cardio.
There is a growing statistic in the states of a group of people, typically males in the post 40 yo bracket who are re indulging in exercise (mid life crisis??) and joining various clubs including triathlon clubs in particular. They train and train then come race day they push that little bit harder in the competitive environment of the day and invariably....drop dead. Perhaps if they monitor their heart and keep a limit on HR they wouldnt be entering these dangerous HR levels. Just being aware of how they 'feel' is not good enough, obviously in a race they are pushing to the max and doing this based on how you feel is a very vague way of monitoring cardio limitations.

Yes, coughing can help keep the heart ticking over in the event of an attack.