When a Heart Attack is Silent

My dad had a heart attack.  Big deal, right?  He’s 65, he has Type 2 Diabetes, and he’s retired – so basically, it was time.  Myocardial Infarctions – all the aging men are having them.  It’s totally the “in” thing to do.  With almost 800,000 people in the US dying from heart attacks each year, it’s not really a shock anymore to hear that someone who is over 60 has had one.

But here’s where things get strange.

On August 11th, my dad suffered a MASSIVE heart attack.  His Left Anterior Descending Artery (LAD), became 100% blocked.  coronary-arteries

As if that wasn’t bad enough, the blockage occurred at the top of the artery, cutting off blood supply to the ENTIRE left side of his heart. This is usually the time when the person is being rushed to the hospital and catheterized to get a stent in to open the artery ASAP.  This is when seconds count.  This is why this particular type of heart attack is referred to as the Widow Maker.

THE WIDOW MAKER.

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Just let that sink in for a minute.

Ok, so my dad had a heart attack and it was bad.  Big deal.  People have bad heart attacks everyday.  Why is that strange?  It’s strange because while his heart was struggling to get blood flowing and essentially shutting down, he didn’t even know it.

HE HAD NO IDEA HE WAS HAVING A HEART ATTACK.

This, my friends, is called a silent heart attack.  While it’s often not really “silent” because you definitely experience a host of other symptoms, it’s not recognized because the symptoms are not the typical clutch your chest and fall to the floor type dramatization that we usually see in movies.  Silent or undiagnosed heart attacks affect nearly 200,000 people a year.  That means that somewhere between 40-60% of heart attacks are UNRECOGNIZED.

If a minor heart attack goes unnoticed for a while, it’s often not a huge deal.  But if the heart attack is big enough (e.g. MASSIVE), and not treated promptly, it can be catastrophic and most often result in SUDDEN DEATH.  Hence the term, Widow Maker.  The fact that my dad had a heart attack on August 11 (the symptoms of which he felt for 4 consecutive days) and survived is a miracle.  The added bonus that he is doing remarkably well, even though his heart is damaged, is really amazing.

So, what does a silent heart attack look like?  Well, for my dad it presented as such:

  • Nausea
  • Sweating
  • Dizziness
  • Fatigue, but inability to sleep
  • A restless feeling
  • Unexplained indigestion
  • Rock hard stomach
  • Inability to think straight at times

My dad is a tough cookie.  His heart attack occurred right after the death of my grandmother, so he was preoccupied with helping my mother and her siblings get through the funeral and events thereafter.  Because he has Diabetes, when the symptoms began, it was easy for him to write them off as blood sugar issues.  At one point he thought he had a virus.  He felt awful and self-medicated by taking Prilosec, Ducolax, and other anti-acid and stomach related medications.  None of these helped.  His usually hearty appetite deteriorated.  While making the drive from Florida back to Georgia (following my grandmother’s funeral), he struggled to keep his head up straight.  He was uncomfortable and while he couldn’t sleep, he felt too weak to keep his head from bobbing.  He had moments of confusion – like when he tried to message me that he was ok, just not hungry, but he couldn’t remember how to spell hungry and so had to ask my mother.  My dad is a healthy, sharp witted person.  He has a great memory and is very independent and self sufficient.  When he got to the point where thought and speech were difficult, we should have rushed him to the ER right then and there, but we just didn’t recognize it for what it was.  Shame on you Hollywood for misleading us!  (That is entirely in jest.  Showing a heart attack without the drama of a collapse would be boring and movies don’t become box office hits from being blah).

OVER A MONTH LATER, my dad was feeling fine (or so he claims) and was at a routine physical with his long time GP when his doctor put the stethoscope down and sent him for an immediate ECG.  His heart didn’t sound right.  The ECG revealed it didn’t beat right.  The next test, the Echocardiogram, revealed that it didn’t look right.  My parents will never forget the doctor’s words, “You had a heart attack … and it was a big one”.

The nuclear stress test wasn’t good.  The catheterization even was worse.  My dad was so nervous about the prospect of having a stent put in, not realizing that not having it put in would be an even worse case scenario.  His artery was so blocked that his cardiologist couldn’t even get a wire through to place the stent.  Lucky for my dad, his heart had already begun growing blood vessels to naturally bypass the clot.  Because of this he did not have to have a bypass surgery.  Also, there really is no point in doing a bypass around a clogged artery that leads directly into a mass of dead tissue.  The damage from having the LAD blocked for so long has been done, and is irreparable.  The goal now is to strengthen the rest of the heart so that his current Ejection Fraction (the measurement of the percentage of blood leaving your heart each time it contracts) of 25-30 gets above 32-33.  The Ejection Fraction (EF) of a healthy heart is 55-70.  If medications and rest can’t help my dad’s heart, he will have surgery to insert a defibrillator in 3 months.  My sister and I asked the cardiologist why he would need this.  His reply, “To prevent sudden death”.

Well ok then.

My dad is one of the lucky ones.  He’s one of those people that doctors and science can’t explain.  He joins a small percentage of people who survived one of the worst kinds of heart attacks a human can suffer and while he swears he feels fine and dandy, those of us that love him do not take this lightly (even though we’ve tried to laugh our way through it for the sake of alleviating the heaviness of the situation).

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My sister pretending to bust dad out of the hospital.  If he hadn’t been threatened by his doctors to stay there, he probably would have taken off – hospital gown and all.

We realize that he has been given a second lease on life and want to share what we’ve learned with those who are going through a similar experience – and more importantly, those who may experience this someday, but are not aware of the signs..  Cardiovascular disease kills more people each year than every type of cancer combined, yet often people are much more worried about the big C than they are heart failure.  I have had several friends under 40 years of age succumb to this disease, and they all had symptoms, just not the typical ones.  Just like cancer doesn’t show up as a “one size fits all” disease, neither does heart disease. According to The Heart Foundation, in the United States alone, someone has a heart attack every 34 seconds.  And no, it is not just men!  HEART DISEASE IS THE NUMBER 1 KILLER OF WOMEN – more deadly than all types of cancers combined.  Since 1984, in fact, more WOMEN have died of heart disease than men.

So what now?  Because heart attacks and symptoms of an impending one can be so misunderstood, it is important to assess your risk.  Do you have:

  • A family history of heart disease?
  • Diabetes?
  • A history of smoking?
  • High blood pressure?
  • High cholesterol or tryglycerides?
  • An inactive lifestyle?
  • A history of preeclampsia?
  • An Autoimmune Disorder?
  • A history of illegal drug use?
  • An inordinate amount of continuous stress?

If you have even one of these, you need to keep a close eye on your heart.  If you have 2 or more, keep an even closer one.  Be faithful to your yearly check-ups and stay active (get active if you’re not already), and eat a heart healthy diet.  As my dad says, you can’t go wrong with vegetables.  Eat em all and eat em often.  (Chocolate comes from a bean so it’s kind of like a veggie, right?).  You know how when you see a mole that looks funny, you run to the dermatologist to have it checked?  You need to do the same when it comes to your heart.  If you are not feeling right, have unexplained symptoms that can’t be controlled through normal venues, get checked out.  If my dad had received help while he was having the heart attack, instead of a month later, he would have most likely preserved a good portion of the heart muscle that is now dead.  For most people suffering from the Widow Maker, prompt attention will SAVE THEIR LIFE.

We joke about having a heart attack all the time.  Why do we do that?  We don’t do it about Cancer.  We don’t say, “Oh my gosh, you almost gave me Cancer,” or “I’m so stressed, I’m going to have Cancer,”.  We’d probably get slapped if we did.  I think we’ve become too comfortable with the term because it is such a common and unexpected event, that we just shrug it off – that is until it happens to us, or someone close to us.

I’m going to leave you with this really neat explanation and video created by a highly respected interventional cardiologist.  My husband tuned me into this after I told him what type of heart attack my dad suffered.  For those of you who appreciate anatomy and science, be sure to check it out.  Even if you’re not crazy for biology, you may find it interesting.  Our heart is the most important organ we have, so let’s do a better job of protecting it.

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Dad and his two favorite daughters :).

 

 

 

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