Part 3 of a 3-part series about pain
My initial heart attack symptoms struck me right out of the blue. I was out for a brisk walk early one beautiful Monday morning around 6 a.m. when suddenly, I experienced a pain smack in the centre of my chest. It felt like a cross between crushing heaviness and a severe burning sensation that gradually extended right up my chest into my lower throat. My left arm began to hurt. I also felt like I was going to vomit, and I started sweating far more profusely than my walking pace warranted.
But a strange realization about my heart attack symptoms hit me much later, long after I was hospitalized for what doctors still call the “widowmaker” heart attack.
This was not the first time in my life I’d felt the chest pain symptoms I experienced on that spring morning.
In fact, over a 19-year pre-heart attack stretch while I was a distance runner, I felt a virtually identical chest/throat pain at the end of my running group’s long Sunday morning training runs. Every week, as we neared the part of our route taking us back to the downtown Victoria Y (where our group runs typically started and ended), we hit the Quadra Street hill.
Quadra Street is the kind of double-whammy hill that most recreational runners dread: it was both long (4-5 blocks) and also memorably steep, leading north from the edges of Beacon Hill Park up to the Y at the top of the hill. Near the very end of the final push up that endless hill, I would start to feel those chest pain/burning throat symptoms. Every Sunday, for 19 years.
Back then, I just figured that this chest/throat pain meant my lungs were screaming for mercy while we pounded up that long steep hill. But I don’t recall thinking anything was particularly wrong with that kind of pain at the time. After all, our entire Y group was pretty much heaving and sucking wind by the time we all reached the top, so I thought everybody felt that way running up Quadra Street.
I don’t recall even bothering to mention what I was feeling to any of my running buddies all those years because I assumed they all felt it, too. And I never attributed these symptoms to my heart, but only to my lungs as I imagined them struggling for each breath under extreme exertion.
But that struggle seemed to ease up after we reached the top of the hill, during our cool-down walk and post-run stretch. I also never felt that unique combination of severe symptoms during our road races or other training runs – only while running up that one particularly long and steep hill. After each Sunday run, I didn’t give those symptoms a moment’s thought until the next week near the end of the the next run up Quadra Street.
Fast forward several years to those first severe heart attack symptoms and my first trip to the Emergency Department on that beautiful spring morning. When the Emergency doc told me that my symptoms were NOT heart-related, it made sense to me. After all, I had never before attributed those familiar chest symptoms to my heart. In fact, had it not been for the alarming pain down my left arm that spring day, I would not likely have sought immediate emergency help at the hospital.
I felt embarrassed for having made a fuss over “nothing” when I was sent home from Emergency with my acid reflux misdiagnosis. But I was also relieved! I’d much rather have indigestion instead of heart disease, thank you very much.
We know that heart disease can be 20-30 years in the making. So I now wonder: is it possible that I had been experiencing early signs of angina all those years, brought on (as stable angina almost always is) by extreme exertion?
We know that women can often experience what are called prodromal (early warning) symptoms of heart attack. As I wrote here, for example, when Arkansas researcher Dr. Jean McSweeney interviewed hundreds of female heart attack survivors, she discovered that 95 percent of the women she studied actually suspected something was very wrong in the months leading up to their attack.*
Well, that’s months – but not years – ahead of time!
While you ponder that possibility, consider what causes the cardiac chest pains of angina pectoris (translated as “strangling in the chest):
My particular type of current angina is associated with that latter diagnosis. The debilitating pain tends to be more severe and last longer than other types of angina pain, and can also occur with severe shortness of breath, sleep problems or crushing fatigue. Ironically, it’s often first noticed during routine daily activities (for me, simply walking down the frozen food aisle at the grocery store can set it off) and aggravated by emotional stress (running late for an appointment, for example, can create an avalanche of debilitating symptoms). I can generally manage the pain most days like this:
- with medications (remember, heart sisters, that “nitro is your friend!”)
- regular daily exercise (as Kentucky cardiologist Dr. John Mandrola likes to say: “You only have to exercise on the days you plan to eat!”
- the portable TENS unit I wear clipped to my belt from dawn to dusk
- anticipating, preparing for monitoring and managing my daily stress levels
- ongoing care from our Regional Pain Clinic staff, an expert pain specialist, and the pain self-management programs offered there.
* Jean C. McSweeney. “Women’s Early Warning Symptoms of Acute Myocardial Infarction”. Circulation. 2003; 108: 2619-2623 November 3, 2003. doi: 10.1161/01.CIR.0000097116.29625.7C
Q: Have you experienced odd symptoms that turned out much later to be early warning signs of a significant health crisis?
- Part 1 of this 3-part series: The Freakish Nature of Pain
- Part 2 of this 3-part series: Brain freeze, heart disease and pain self-management
- On being a (former) runner – my guest column in Runner’s World
- How women can tell if they’re headed for a heart attack
- Researchers openly mock the ‘myth’ of women’s unique heart attack symptoms
- 12 heart attack symptoms you must never ignore
- Women fatally unaware of heart attack symptoms
- Mayo Clinic: “What are the symptoms of a heart attack for women?”
- When chest pain is “just” costochondritis
- The chest pain of angina comes in four flavours
- Women’s heart pain is both physical and emotional
- Self-Tracking Device? Got it. Tried it. Ditched it. (from The Ethical Nag: Marketing Ethics for the Easily Swayed)