Judson Haims: Heart Attack – No symptoms and misread signs lead to ’silent’ heart attack
Special to The Aspen Times
Recently, I had a heart attack and did not even know it. Often called a silent heart attack or a silent myocardial infarction (SMI), this type of heart attack accounts for most of all heart attacks. Research from the American Heart Association and Harvard Health find SMIs may account for 45% of heart attacks.
For the past four or five months I had been talking to my primary care physician (PCP) of concerns that while exercising, I was maxing out my heart rate at 140 beats per minute. At sustained heart rates beyond 140, I felt I couldn’t catch my breath. At 55 years of age and being relatively fit, I should be maxing out at either side of 170-ish. Something was wrong.
One of my passions is mountain biking. Unfortunately, for quite some time, my ability to ride the way I wanted had been stifled because of a bad knee. After a long ride, my knee would become inflamed and soar impeding me from riding multiple consecutive days. Further, long and brisk walks had also been challenging. Despondent, my physical activity subsided and over time, I had put on about 10-15 pounds.
Three years ago, I had a knee replacement. I had been avoiding it for years as outcomes were not at levels which I felt comfortable and the amount of time in which they lasted were too short. With the advent of new technologies, less invasive surgical methods, and quicker recovery times, I changed my mind and ultimately, my lifestyle.
Ever since, I have been enjoying a level of physical activity not experienced for many years. Surgery rehabilitation got me motivated to spin on a Peloton at the gym not just for rehab, but also as a part of my weekly exercise regimen. I’ve lost weight, lowered my body mass index (BMI), lowered my cholesterol, and I am eating better.
Although it has taken some time getting to a point where I can do the rides I want within a competitive timeframe I’ve held myself to, I have been finding it challenging to reach heightened levels. I seemed to have hit a wall.
Even after spending the past few years exercising both in and out of the gym, I have found I cannot get to the physical endurance levels I have set for myself. It’s been demoralizing. I’ve spoken with my PCP about it, and even sought the advice of athletic trainers. All to no avail.
A few weeks ago, I may have found out one of the reasons why my ability to push forward had been stifled. I had a heart attack. There were no typical symptoms nor signs — no piercing heart pain, no pain in the arms, neck or jaw, and cold sweat. I simply felt short of breath as I have so many times while exerting myself.
After getting off the Peloton early one morning, I found I was having difficulty regaining my breathe. While my heart rate monitor showed I was at about 100 BPM, I felt like I was at a much higher rate. For quite some time, I sat on a bench and attempted to regain my composure. After about 30 minutes, I drove home. When I arrived, I asked my wife to sit with me and I explained how I was feeling. She immediately became concerned and after waiting a few minutes, called 911.
Once the paramedics arrived and asked a few precursory questions, they connected me to an electrocardiogram (EKG), which showed the electrical activity of my heart. I don’t think the paramedic connected the last electrode before informing me that I was coming with them to go to the hospital. Incredulously, I asked why and was told I was in the middle of a major heart attack. Hmm … go figure.
Unfortunately, medical providers and our current health system are not utilizing all available tools to educate us of our heart attack risks. Guiding patients to monitor our cholesterol levels, eat a healthy diet, and get exercise daily is only a part of what it takes to mitigate risk. Perhaps a more effective approach to reducing the prevalence of heart attacks may be to monitor heart risk in a similar manner as women monitor breast cancer — with an annual scan.
Even though blood testing for cholesterol, triglycerides, C-reactive protein, and myeloperoxidase (MPO) may help predict an early risk of heart attack, they do not offer much insight as to the imminent risk of heart attack. While not inexpensive, diagnostic cardiac imaging often provides better insight to the condition of an artery before an event occurs.
Cardiovascular tests such as a nuclear stress test, cardiac magnetic resonance imaging (MRI), or cardiac computerized tomography (CT) scan, will show parts of the heart muscle that are not receiving normal blood flow. These tests may be useful when deciding the next steps in treatment.
Not all heart attacks are painful and traumatic. SMI symptoms can be so mild that, like in my case, get overlooked. Shortness of breath, chest discomfort, breaking out in a cold sweat, and feeling nauseated or lightheaded are classic signs of concern.
I got a get out of jail free card. Not everyone may be so lucky. If you ever feel that you are experiencing a sensation like a strained a muscle or discomfort in your chest, arm, jaw, or upper back do not ignore it. A simple EKG may be all you need to put concerns behind you.
The quicker you take action when experiencing potential symptoms of a heart attack, the better. With every passing moment you choose to be in denial and not address a possible concern, your heart muscle may be dying.
Judson Haims is the owner of Visiting Angels Home Care in Aspen, Basalt, and Carbondale. He is an advocate for our elderly and is available to answer questions. His contact information is http://www.visitingangels.com/comtns or 970-328-5526.