What to do when you can't remember the symptoms of a heart attack

Tuesday, May 24, 2022

Short read option


If everything else about heart attacks falls out of your head, just remember two things:

  1. Heart disease is the #1 killer of both men and women (and not just older men and women)
  2. The symptoms of a heart attack often have nothing to do with the heart so give a detailed description of your symptoms to your medical provider and ask, “Could these symptoms be related to my heart?” That’s a nudge of a question that could save your life.

 
Longer read option


You know how you can block certain critical pieces of information no matter how many times you try to commit it to memory? How to work a remote, the medication your child has a sensitivity to, a co-worker’s name. I have a bit of that block with the symptoms of a heart attack. I know them and yet I kind of don’t. Or maybe I do. All I really know for sure is that when I read another article about how many of the symptoms of a heart attack in women are kind of off-topic – jaw pain, back pain, shortness of breath, cold sweats, fatigue, general malaise, nausea, indigestion --- the information feels very unstable in my memory, like I’m not going to associate those symptoms with the real thing if it happens.


Apparently, a lot of other people also have a bit of a block against that – including the medical field according to an article in the May 9, 2022 New York Times. The result of all this lack of clarity is that women wait a lot longer before calling 911 or going to the hospital and once there may receive less thorough evaluations and are less likely to receive an EKG or be administered other tests that can detect cardiac problems. Because of that, women suffer worse outcomes including higher rates of death.
But there’s more. In addition to having “Man Thing” written all over it and a full menu of murky heart attack symptoms having nothing to do with chest pain, there’s something else confounding the problem for women. According to a recent study noted in the Times article, “heart attacks and death from heart disease are rising in younger and younger women between the ages of 35 and 54, in part because of an increase in cardiometabolic risk factors like high blood pressure and obesity.” So it’s not good.


But just to be clear, it’s not good for anybody. Men can also have a heart attack without chest pain (36% to women’s 62%) which is an important fact to know given that heart disease is the leading cause of death in both men and women. And while we may not be able to remember how to work a remote or remember all the murky symptoms of a heart attack, surely we can remember that heart disease is the leading cause of death in both men and women and that this disease is coming for us at younger and younger ages. It puts having a heart attack in the realm of possibility for both men and women over the age of 35 when a whole host of non-heart specific symptoms crop up – back or jaw pain, shortness of breath, fatigue, a general sense of not feeling right.


All you have to remember, according to Dr. Andrew Ehrhard, the Medical Director of EMMC’s Emergency Department, is to provide a detailed description of your symptoms and ask one critical question:


“Could this be related to my heart?”


That nudge helps ensure any possible problems of the heart are entered into the realm of consideration. And it’s not a question to save for a trip to the Emergency Department. Those murky symptoms could precede a heart attack by a month or more so, “Could this be related to my heart?” is absolutely a question you should bring up with your primary care, as well.


In the midst of all the concern reading the New York Times article brought up about women being left off the heart attack radar, it was very reassuring when Dr. Ehrhard told me about the joint practice protocols at EMMC. Should some of those murky symptoms come up at the point of triage, this protocol allows the triage nurse to initiate a series of tests (so don’t skimp on the details of your symptoms). One of those tests at EMMC is a high sensitivity troponin test, a blood test measuring heart muscle cell damage, and high sensitivity because it distinguishes the threshold of concern between men and women, with the threshold for women being 16 while the threshold for men is 22. Those 6 points matter where a woman’s heart is concerned.


If everything else about heart attacks falls out of your head, just remember two things:

  1. Heart disease is the #1 killer of both men and women (and not just older men and women)
  2. The symptoms of a heart attack often have nothing to do with the heart so give a detailed description of your symptoms to your medical provider and ask, “Could these symptoms be related to my heart?” That’s a nudge of a question that could save your life.

To long beating hearts,
 
E