Monday, October 24, 2005

More Than You Wanted to Know About My Heart Attack

A lot of my readers have asked me to tell the full story of my heart attack--so here it is.

At the age of 37, I thought I was in great health. I had run regularly from the age of 12, worked as a weight trainer at the New York University gym and practiced karate. Although I never thought I was invincible, I had no idea that I would have a heart attack. My family had always had a history of cancer so I figured that if I got sick, this would be my fate (hopefully later on down the line). However, one day I finished working out in the gym and was driving home with my husband when I became short of breath. It was an awful feeling--I felt like I was smothering to death and going to pass out. My husband called 911 and was told to get me to the nearest hospital which he did.

Despite the fact that I was short of breath and shaking like a leaf, the doctor decided I was allergic to something in the gym and gave me a shot of benadryl. Actually, I later learned that shortness of breath and a sense of impending doom or death were signs (especially in women) of heart problems. I felt ok once I left the hospital and even for a week or two later. I was on vacation in Charleston, South Carolina when I again got short of breath and could not walk. I was so dizzy, scared and light-headed that I spent the day in bed until finally that night, I went to an emergency room. I told the doctors about the allergy reaction that the last emergency room thought I had and they tried some breathing treatments for asthma.

Amazingly, while in the emergency room, a man in his thirties or forties came in with shortness of breath. He was whisked off for heart tests and his wife and two little children were there crying. I felt so sorry for them. Later, I saw a doctor telling his wife that he had stomach problems and his heart was in good condition. If only I could have said the same! The doctors finally did an EKG after I told them that the breathing treatments were not working. The results said that I had a possible MI. A cardiologist came into the room, looked at the reading and shrugged, stating that many thin women in their 30's who were athletic had a similar reading. I took his word for it and left.

Two doctors and an emergency room visit later, I still had no answer to why I was shaking, short of breath and could barely walk at times from weakness. I thought at times I was having mini strokes. One emergency room doctor refused to look at my abnormal EKG when I came to the hospital; he was too busy dealing with a female coke addict and decided that I was another example of an anxious woman having a panic attack.

I finally persuaded my regular doctor to quit prescibing me Effexor (an antidepressant) and to look at my heart. He finally sent me for tests. He called back and told me to get to the hospital. My father was with me at the time and took me to the hospital where the orderlies thought he was the one with heart problems and told him to get in the wheelchair. I would have laughed myself silly if I had not been so ill. I had tests including a heart cath that helps doctors to see inside the heart. Later, when I was back in my room, the cardiologist came in and told me that I had suffered from a heart attack and also had a ventricular aneurysm (a ballooned out area of the heart) as a result of not resting my heart after the heart attack. I had been told that I had panic disorder so I thought that exercise would be good.

I would like to say that once I got treatment that my problems were over but they had just begun. I was sick with panic attacks for several years. Finally, after more tests in February of 2005, I was told I had ventricular tachycardia and venticular fibrillation (which was triggered during testing). A few days later, I received an ICD (implantable cardioverter defibrillator) which is a device that will shock you if you have a serious rythm problem. I also received the life-saving drug Tikosyn, which is so potent, I had to take it for five days in the hospital to make sure I could tolerate it.

For the first time in years, I feel almost normal. I give thanks everyday for the amazing advances in heart research over the past 15 years. I know it sounds cliche, but I feel lucky just to be alive. When other people in their thirties and forties complain about their aches and pains, I just laugh--I feel lucky to get up in the morning without feeling dizzy or nearly fainting.

Women have been led to believe that breast cancer is the number one killer of women. This could not be further from the truth. Almost one half million women die each year from heart disease. Breast cancer kills only 40,000. The sad part is that half of all the women who have a heart attack each year die before they reach the hospital. I believe this is partly because women do not take symptoms of heart attacks seriously--they wait too long before going to the hospital and do not address heart issues with their doctors. Doctors are to blame at times; they buy into the myth that women are more likely to get breast cancer and that heart disease is for men. In order to change this, women must start asking their doctor to discuss heart disease prevention with them from an early age and to demand testing if they have symptoms. Hopefully, awareness of heart disease will infiltrate the public in much the same way breast cancer awareness did--but it will not begin until women decide that red dresses for heart disease are just as important or maybe more so (given the large number of women dying) than pink ribbons are for breast cancer.

Update: Here is a link to my story and more info on women's heart facts at www.medtees.com.

182 Comments:

Anonymous Anonymous said...

Thank you for sharing your personal story. And thanks for all the careful, fairminded material you write. I hope that your health continues to be good and stable...and that you continue to share your thoughts with all of us for a long time to come.

-MM

1:35 AM, November 07, 2005  
Blogger jau said...

Thanks for this detailed and important story. I'm going to link to it on my blog and hopefully that will increase awareness.

Is one meant to wear red clothes at any particular time, to show support? I've never heard of it but will gladly join in.

9:53 AM, November 07, 2005  
Blogger Baillie said...

The only diagnosis they could fit me under ten years ago was fibromyalgia. Finally, last spring, my rheumatologist came to the conclusion that something else was going on, since standard treatment for fibromyalgia wasn’t curing me of the worsening exhaustion and pain, so he told me to get a more few tests done.

Consequent experience with disapproving neurologist, who clearly didn’t believe in fibromyalgia: Have you seen a psychiatrist? Is your family life happy? Do you exercise? You’re deconditioned. Have you increased the narcotics dosage? Have you talked to a psychiatrist? Your muscles are out of condition. Any family problems?. I’ll have the desk set you up for physical therapy. Have you seen a psychiatrist? You’re deconditioned. Have you considered this different drug for muscle burning instead of the narcotics -- oh, I don’t want to get involved in this.

A month later, a cardiologist diagnosed me with cardiomyopathy, a serious heart weakening that will considerably shorten my life if the pills don’t work miracles.

I haven’t gone back and bitten the neurologist yet, but I’m tempted.

12:41 PM, November 07, 2005  
Anonymous Anonymous said...

Dear Dr. Helen,

Thank you for posting this story. I had been very curious, but had thought it inappropriate to ask. Since you've been open enough to tell the story, though, perhaps I could ask a few follow-up questions. First, to what extent, in your knowledge,is an event like this unusual in a pre-menopausal woman? I'd been given to understand that heart attacks were extremely rare in pre-menopausal women, although rates of heart disease in post-menopausal women equalled those of men. Is this just a widespread fallacy? Second, what kind of prevention information and advice -- beyond a guide to recognizing symptoms -- do you think might have helped you avoid a heart attack? It sounds as if you were leading what we are all told is the archetypal heart-healthy lifestyle, and had absolutely no predisposing medical conditions or symptoms. Do you think your heart attack could have been prevented? Or is the best we can hope for just to recognize the signs of a heart attack when it occurs? Finally, if you think you're having a heart attack, what tests should you insist be performed at the hospital?

I hope you sued the doctors, by the way.

9:12 AM, November 08, 2005  
Anonymous tony said...

thanks for sharing your story with us!

1:55 PM, November 08, 2005  
Blogger Helen said...

Hi Everyone,

Thanks for the nice comments etc. I will try to answer some of the questions about my heart attack. Yes, 9000 women under 40 have a heart attack every year--and there are many like one of the commenters who have cardiomyopathy which is a very serious heart disease. I had a roomate in the hospital this year who came in with viral cardiomyopathy with an ejection fraction of 18% (normal is over 50).

Do I think my heart attack could have been prevented? The damage could have been, perhaps had I been tested for heart trouble at the time of the heart attack. Doctors told me I probably had a coronary spasm which women are prone to due, I think, to smaller arteries. Docs say perhaps a blood clot got caught in one of these arterial spasms and caused the heart attack. I was on birth control pills at the time and was told that could possibly have caused the blood clot--I have never taken them since.

I thought that my lifestyle was very healthy--running,weights etc. and eating very little fat--some people thought I had a heart attack because I was too thin! I had to laugh because my weight was not that low at the time --115 and five foot six. I do think gaining ten pounds has helped me feel better and I really cut down on the stress--especially at work.

As far as tests I would reccommend women ask their docs about--the echocardiogram is the one that caught my problems--it is, as many of you know, non-invasive and shows a lot. The stress test is ok but I have heard it is not that great for women. A holter monitor caught my v-tach.

As far as invasive procedures, I had two heart caths which are only needed if there is a problem and 2 electrophysical studies to look at my heart rhythm problems. These are invasive and I found them rather unpleasant, except for one of them as the mix of meds was really good and I was smiling the whole time they were explaining the V-Fib. It wasn't until later that I realized the cardiologist was telling me I had a deadly heart rhythm problem.

If you want more info on women's heart health--go to www.medtees.com and click on defibrillator t-shirts. I am modeling a shirt for the site and the cardiologist who runs it put on stats and info on women's heart health!

No, I did not sue the doctors. I wanted to but a lawsuit was too stressful for me. I did get a call from the head of an ER department that turned me away and told him rather than sue him, I wanted him to give a lecture to the doctor who treated me badly and his staff on women's heart health. Although I was too sick to attend, he called back to confirm that he did it. I can only imagine the next time a woman comes to that ER with shortness of breath,etc. Hopefully the doctors will remember that lecture.

4:56 PM, November 08, 2005  
Blogger SIMON said...

It's too bad that there are still some health care professionals who are unaware of the atypical cardiac symptom presentation of females. It's truly distressing to see.

Thanks for sharing your ever-enlightening story. Good luck with your restored health.

Simon, RN

3:51 PM, November 12, 2005  
Blogger Geoff Webb said...

I had a heart attack this past summer at age 37. If there is one thing I want to shout from the rooftops, its don't believe the movies!
When I had mine, I walked into the ER under my own power and breathing fine. I thought I had really bad hearburn, and was humoring my wife. Her intuition saved my life!
It doesn't happen like in the movies folks! Men can have mild symptoms. Women can be completely without symptoms.
So how do we get the word out? Obviously even medical professionals need this info.

3:12 AM, November 20, 2005  
Blogger Helen said...

Hi Mr. Webb,
Glad you are ok to tell us about the heart attack. I really do not understand why no one wants to take symptoms seriously. My own siblings laugh when I tell them to get checked out. And just try asking a doctor to check out a child's heart. It is met with amusement and annoyance. Kids have rhythm problems too--but we just wait until something bad happens to take any precautions. I do not want others to know what it is like to live with a heart that is compromised. It is a daily struggle.

7:55 AM, November 20, 2005  
Blogger Kurmudge said...

What did they say about doing an aneurysmectomy to deal with the thin spot in the LV?

I know that there are scar tissue issues with thta surgery in the olden days (20+ years ago), but one would think that today we would have some better means to manage the post-op healing process (reducing scar tissue formation-that seems to have a lot to do with how invasive the whole thing is and how much of an artist- vs. mechanic- the surgeon is), and also that there is a big difference between the usual 60 year old patient and the Dr. Helen-types.

I assume they said that the risk of rupture is low enough that the weak contractile spot is better managed conservatively?

2:02 PM, November 20, 2005  
Blogger Helen said...

Hi Duane,

Yes, my aneurysm in the left ventricle is just managed by watching it and with the ICD implant as the scar tissue around the aneurysm was causing major electrical problems. At this time, it is not in danger of bursting as that is quite rare. I do have to keep my pulse rate under 120 as the cardiologist says he does not want me to put strain on the aneurysm. This has gotten easier over time as in cardiac rehab I can manage my heart rate and I know how fast I can exercise.

4:09 PM, November 20, 2005  
Anonymous Anonymous said...

Dear Helen,

I have been a practicing internist for 28 years and I have never seen a 37 year old woman with a myocardial infarction. That's not to say that your treatment was proper in the ER's - it seems not to have been. But nor is it correct to think that this is an everyday sort of thing. It's just not true that premenopausal woment have much risk of heart attacks.

Little comfort to you, I'm sure, that your condition is a rare one. But it is certainly part of the reason you were not treated well. I truly hope it's mostly behind you now.

Bernard

5:23 PM, November 20, 2005  
Blogger Geoff Webb said...

Dr. Helen, I was lucky, and they were able to interrupt things before there was much damage to my heart. The cardiologist that treated me said my case was unusual, but by no means rare.

Bernard, why wouldn't heart trouble be one of the first things to eliminate with someone presenting with chest pains?

I'm mostly concerned about educating the average joe. So many people think that a heart attack is some sort of dramatic event, that they don't realize the symptoms can be quite subtle. It has become a personal crusade for me.

I'll have to let the medical professionals sort themselves out.

Geoff

6:14 PM, November 20, 2005  
Blogger Dr. Goodheart said...

Dear Dr. Smith,
I've been a cardiologist for over twenty years. I've had three relatively young women with major heart attacks who had no cardiac risk factors; two were in the past couple of years, and both women had been taking Maxalt for migraines prior to their heart attacks. Maxalt can cause coronary artery spasm. Yes, their symptoms were not recognized for too long. Unfortunately, atypical symptoms in both men and women are often unrecognized.

7:09 PM, November 20, 2005  
Anonymous Anonymous said...

I am ashamed that there are so many docs that do not listen and EXAMINE their patients.If your doctor does not listen to you and actually physically examine you...get a new MD. The ER has its own special set of problems and that is due to a number of various factors....none however can be used to excuse good patient care.
a TN MD

8:19 PM, November 20, 2005  
Blogger Kurmudge said...

I'm just extremely concerned that Dr. Helen will have a terrible time always keeping her heartrate moderated to <120 when it speeds up and flutters all the time whenever thatReynolds guy comes into the room.

Er, it DOES speed up then, doesn't it? After all, he is described as a "rock star" all the time......

9:32 PM, November 20, 2005  
Blogger Helen said...

To anonymous (the internist):

Perhaps you have never seen a woman in her 30's with a heart attack--it does not mean they don't exist. They are not really as rare as you think. I am sure my doctor who I begged to check my heart could say the same because if he treated others like he did me--he would never see a heart attack--you just send someone out with Effexor and tell them good luck.

My point is that doctors are constantly talking about all the knowlege they have to diagnose--this is what I hear when medial doctors do not want psychologists to prescribe drugs--then when they get a more challenging case, they simply categorize the patient without looking further. It is not just heart attacks which are missed--it is also heart conditions such as cardiomyopathy, heart block, rhythm problems etc. If you add all of these problems in, there are more premenopausal women who have heart problems than you realize.

8:16 AM, November 21, 2005  
Anonymous Anonymous said...

Well, I guess you told me where to get off. My bad.

4:23 PM, November 21, 2005  
Blogger Helen said...

To Anonymous,

I did not mean to come across as rude--I am certainly sorry if I did! I do realize that I am a bit of an anomaly but not that much. I just do not want another person to miss getting the chance at help. I suppose my rant would have been better served directed at the actual doctors who did not listen but I was too sick at the time to do so. I apologize if I came on too strong.

6:50 PM, November 21, 2005  
Blogger Echo Mouse said...

Thank you so much for this post. You're the second blogger I've read this week who shared the stats of breast cancer vs. heart attacks. The pink ribbon campaign has been getting on my nerves for a couple of years now. Granted, it's a great idea. But it's overshadowing the other forms of cancer, such as brain cancer, which are much more serious. Not to mention the heart & stroke research needs.

I am very glad you survived this ordeal. I lost a sister to a bad heart when she was 46. She struggled for two years before she passed, so I can imagine what your daily life is like at times. For you to share this, making it available easily for others, is wonderful.

I applaud the way you handled the idea of a lawsuit. Educating doctors, as you requested, will do far more than any lawsuit. And it didn't put your own health under further stress. You are a great example people can learn from.

Thanks again for this post. It's fantastic.

7:56 PM, November 22, 2005  
Blogger Helen said...

Hi echo mouse,

Thanks for the nice comment--I just wanted to say I am sorry about your sister. People do not understand that it is hard to live with heart disease or to live with or care for someone with these problems.

It is difficult to describe to people what it is like on a daily basis to have a poorly pumping heart. It is sometimes hard to explain to someone that you cannot walk up a steep hill despite the fact that you look well. I love it when I am at the gym and someone comes up to tell me I need to work out harder. I just say I am glad to be there walking!

10:05 PM, November 22, 2005  
Anonymous Anonymous said...

I found your blog very interesting and I hope that you are well in the road to recovery. Three women in my life can relate to what you have been through. My mom had a heart attack a few years ago and luckily she has recovered. My girlfriend is a cardiologist and she expressed concern about how women cope with heart diseases which most people equate with aggressive male behavior. My daughter is studying psychology and we have discussed why heart issues are ignored or get less attention than breast cancer when it affects more women. Could it be due to the disfiguring effects of breast cancer (masectomy, hair loss w/ chemotherapy)? Is the underlying obsession with physical beauty the reason why heart problems take a lower priority?

3:37 AM, November 24, 2005  
Blogger Helen said...

Hi Anonymous,

Yes, I actually think it is reverse discrimination on the part of women to some degree. Breast cancer may take away their breasts which is important because they have to look good--so it is a high concern. Women get very emotional about something that may take away from their femaleness.

You can see this in the fewer number of women who get heart defibrillators. Women account for only 28% of defibrillators--they can be a bit disfiguring although I wear mine as a sign of pride and when people see the scar, I just tell them I was in a knife fight which sounds a lot cooler than, "I had a heart attack and then had this thing put in my chest." Defibrillators are a medical device that people associate with something older men get. Not that some older men are not cool.

7:18 PM, November 24, 2005  
Blogger a psychiatrist who learned from veterans said...

Another side of discussing your medical history is that you get the equivalent of 'crank mathematicians' calculating what is wrong with you. In that spirit, you know there is school of thought that inflamation can be an issue in heart disease, not just modern lipid buildup. I would think PubMed might cast some light on who is doing that kind of research or what questions to ask.

9:33 PM, December 01, 2005  
Anonymous Anonymous said...

As an emergency doc, I can tell you, you never know what you will find when you start looking. It is very rare for a young woman to have a heart attack from cardiac disease unless she has chronic diseases for a long time like hypertension, diabetes, or a long time smoker. In an apparently healthy young female, "zebras" as we call them may hide out.

There are other conditions that can secondarily cause heart attacks like clots in the lungs (pulmonary emboli) that when large, can severely strain the heart and the increased workload can lead to an MI. Or one of my patients earlier this year continued to complain of shortness of breath and the CT done to look for a clot, actually showed a "dissection" of the aorta that spread down into a coronary artery, thus blocking blood flow to part of the heart again causing an MI. This is a condition that was not classical as there was NO sharp pain radiating into the back as a dissection would look like "classically".

Very mysterious thing can happen to both men and women. "Classical" presentations of some deadly disease can occur only 30% of the time. The other 70% will be very odd presentations and will fool ALL physicians.

11:17 PM, December 10, 2005  
Blogger Jim said...

I am a 46 year old male writing from my hospital bed two days after my first unexpected heart attack. I had been to the doctor twice before in the past 20 days with complaints of severe heartburn. The first time an EKG was done to rule out my heart and I was advised to try prilosec and the second time (last Wednesday, Jan 11) I was back in the office as the prilosec was no longer working. It never had real well. I was sleepless most of Tuesday and Wednesday nites. Wednesday AM I walked from work to my clinic and asked for something more powerful. After an upper GI xray I was advised that I was suffering from severe reflux and given prevacid to try. Very little sleep that night and I managed to make it into work Thursday and again walked to the clinic. By this time I was in severe pain in my chest and was wheeled to see the on call doctor and then to the emergency room. EKG and blood test indicated heart attack. I was transported 85 miles to the nearest Cath lab and underwent angiogram.

In spite of my miserable diet I was told that my coronary arteries were spotless and there was no sign of CAD. My heart attack was caused by a blood clot that travelled deep into a CA and became wedged there. It was apparently difficult to remove. I am now waiting to have tests to try and determine where the clot came from and if there are any more out there. I would appreciate any information I can get on questions to ask or suggestions. When I had my heart attack there was a bottle of Pepto-Bismol in the cup holder of my car. It's not always heartburn! If it doesn't get better go back to the hospital.

3:16 PM, January 14, 2006  
Blogger CCMCornell said...

I don't know if you still read the comments for this post, but I had a question regarding Effexor. You said that you wanted to get your doctor to quit prescribing it to you. Do you mean that you were on Effexor and wanted to stop or that he was trying to give you Effexor to help with your symptoms? If the latter, why would he prescribe that? If the former, is there some risk of Effexor and heart conditions?

I ask because I'm currently on 300mg/day of Effexor. I'm a 26 yr old male. At around age 5 I had an angioplasty to correct a valve that wasn't fully opened. I didn't understand any of it at the time, but was later told that it was done just in case it developed into a problem later at around age 30. I believe the diagnosis was pulmonary stenosis. I'm also told that I should be fine except for a harmless heart murmur.

My psychiatrist and GP both know of my heart history and, of course, the Effexor. But, they said I should be fine. Of course, other docs told you things that turned out to be false.

Also, my mom recently had a mild MI, but she's older - early 50's at the time. Fortunately, she's an ER RN and was on duty at the time and recognized the symptoms early, so in the end there was no damage. Though I guess she is in a higher risk group due to age than you, she's also quite fit, lean and active, so it came as a surprise. She and her docs believe it was stress related, with a divorce going on and working all that OT ER RN's do.

2:12 AM, January 18, 2006  
Blogger Helen said...

ccmcornell,

Sorry that I am just now getting back to you--I don't always check older posts but try. Anyway--I was given Effexor to help with the symptoms I was having--shortness of breath and panic attacks. My primary doctor thought I was having anxiety attacks and gave me the meds to help calm them down. They did not help and I told him that something was wrong and that is when he mentioned the heart and I begged him to give me the tests! I was having panic attacks all day for weeks--they were really cardiac arrythmias causing a panic reaction. The Effexor did not cause my heart problems--at the point I took it, I had already had the heart attack. Sorry to hear about your mom, I am so glad she was astute enough to catch the symptoms before she had permanent damage.

3:42 PM, January 21, 2006  
Blogger CCMCornell said...

Dr Helen,

Thanks for replying. It's a good thing you weren't on it for too long, since Effexor can itself cause cardiac arrythmia, though rarely, as I was told.

Thanks for clearing that up - I just wanted to make sure there wasn't some other heart related warning of Effexor.

When I started on Effexor, my shrink checked me out (especially because of my aforementioned heart condition) and didn't notice any problems. I haven't noticed any either. The only "panics" I get related to Effexor are when I run out and realize I didn't refill - the withdrawal effects after only a day or so are pretty bad. In fact, as I take the pills in the morning, I usually end up with withdrawal symptoms in the early morning just prior to waking up - cold sweating and vivid, stressful dreams almost nightly. But it's not as bad as going off of it for a few days. On the bright side, it's a great biological alarm clock.

2:10 PM, January 26, 2006  
Blogger Internal Medicine Doctor said...

that's weird , just reading the intial story I would have bet on pumonary embolism. but a cath decides it all. sorry fro your heart problems, hope you are able to control them well.
Doctor

5:24 AM, January 28, 2006  
Anonymous Anonymous said...

If you had presented to me with those complaints, this is what I would have done:

1) Listen to the heart for arrythmias.

2) Order EKG

3) Order cardiac enzyme panels for troponin, CK-MB, etc.

Now there is a good chance that none of those things would pick up the MI. The sensitivity and specificity of those tests are not great.

I would NOT order an echocardiogram, because the chances of finding something important in a young healthy woman with no cardiac risk factors is outbalanced the expense and resource utilization.

They should have at least listened to your heart and ordered an EKG, but other than that I cant fault them for anything. If you are going to give every healthy woman with initial chest pain an echo with no other confirmatory testing, then health care expenditures would skyrocket even more.

9:35 PM, March 14, 2006  
Anonymous Anonymous said...

welcome to my world. My wife has a serious case of Multiple Sclerosis (is there any other) and it is a constant, unremitting uphill battle to convince people that she is sick. I cannot tell you how many times various medical professionals have dismissed or misdiagnosed something because they feel it is "all in her head". I wish I had a nickel for every young, male doctor who was thoroughly convinced that she was making her symptoms up. When men have a cold (I am a male) they feel like they are dying but women have to be dead to be considered sick.

4:15 PM, March 17, 2006  
Anonymous Anonymous said...

Thank you so much for sharing your story. I am a 30 year old woman with a baby under one year - and I had NO symptoms of any heart issues while pregnant, but I did before and after. So I thought - "oh, hormonal?" I don't know! So when I brought it up to my nurse practioner (woman), she said to "keep an eye on it" and if I was still concerned, then I could be hooked up to a monitor. So a few months after my baby was born, I began having heart palpatations again. My heart raced and pounded like it was going to fly out of my chest - no pain - just scary. No incident would precede these episodes. Most times I'd be relaxing or simply cleaning the house. So I decided to go back to my doctor and actually see him vs. the nurse practitioner. He said it's probably panic attacks and anxiety because I'm a new mom. Please! I also said I had them prior and he said that I've probably had anxiety issues from before getting pregnant. That didn't explain why nothing happened while pregnant. Anyways, then I thought to INSIST on the monitor and going for a echocardiogram. I have no results on the echo yet, but the monitor revealed that I have OVER 650 extra heartbeats PER DAY. And that was only ONE day where I only felt ONE incident. There are many other days were I feel a ton more! So things were happening when I wasn't even feeling them. So my doctor wants to put me on a betablocker, but I plan to have more children (or maybe one more) and I don't want to risk going on that medication because it's contraindicated in pregnancy and you can't just "stop" it - you need to wean off. My doctor said that I could also just do "nothing" and see how I feel because it's not that big of a deal. Ok - .... so last week I had two episodes of sudden severe pain in the chest area that lasted a few minutes - but I figured it was indigestion / gas.... and now today I have severe radiating pain under my left shoulder blade. BUT I have chronic recurring back pain in that area from an old injury so I'm unsure if it's that flaring up or a symptom of something cardiac. I'm so confused!

2:49 PM, April 24, 2006  
Blogger graham strouse said...

Helen,

I think I know how you feel. I've been suffering from chronic fatigue & anhedonic depression for several years now. I'm 33. I still look good, still have the six-pack abs and all that & am the only 175 pound man I know who can do handstand push-ups.

But 15 years of psychiatrists, who, it seems, have abandoned "First, do no harm" for "First, let's see what happens when I push the OTHER red button" or possibly they just listen to bootleg copies of Jefferson Airplane's "White Rabbit" as part of their residential training. Couldn't say.

It has not been kind to my limbic system, among other things.

I still have excellent muscular strength but need to load up on Provigil and Concerta just to be able to get out of bed and out of the house.

Lovely.

When I try to explain to people that I spent 4 hours in the gym because that's what I need for a one hour workout, they tend to be skeptical.

If I want sympathy, I tell 'em about how my cancerous right testicle got whacked off the day after my closest friend killed herself--and that I found out about it on 9/11.

Nice touch, huh?

It's not funny at all, really. I don't think about the cancer so much. I think about Pam all the time & I think about how badly I want to find a way to get the Superfund project that is my nervous system patched up so I can start living a little more like a human being & tell the welfare people what I think of the helping professions in NC-17 language.

Most people have eyes for the obvious, you know?

So yeah, I do know how frutrating it is to have people look you over and go, "Meh, nothing wrong with you."

It is what it is. Most people want a hand up, not a hand-out. That's not Woody Allen whining on the couch and there's no shame in it. But it is a distinction most people don't see.

Anyway, Helen, it's like the man says:

"I feel your pain." ;)

2:09 PM, May 03, 2006  
Anonymous Anonymous said...

I am a 26 yr old female who needs to lose about 20-25 lbs. I don't exercise as much as I need to, sometimes skipping a week. I 've always had perfect BP- 120 over 80, 110 over 60 or 70....I think my cholesterol is high b/c it seems my father's side of the family all have exceedingly high cholesterol,regardless of diet. My mother's father passed away of a heart attack & my father's parents I believe also died of heart related illness, but they were quite old. My paternal grandmother was the first woman in Ireland to have a pacemaker imstalled in the 60's. I started having panic/anxiety attacks 5 years ago- oddly enough about 3 days before 9/11.....I figured they were brought about by my little weed habit back in those days- paranoia, etc. It seemed every time I smoked I had vertigo, heart palpatations, feeling like I was going to die. I quit smoking pot b/c of it. I sometimes had attacks while completely sober, usually due to stress- & I'm a very emotional person, wear my heart on my sleeve, etc/ --although they quieted down & then compltely disappearred in 2004, when I was pregnant with my son- I refused to allow myself to have a panic attack with another life inside me who would be able to feel my panic, stress & fear & I never even felt one start the whole time I was pregnant- I was very calm, very happy. I felt very safe.. And in the 18 motnhs since I gave birth, I've been ok. Until tonight, at work. I work in a comedy club waitressing, which is extremely fast paced, on your feet, stressful work. The a.c. had accidentally been shut off so it got to be about 82 degrees in there & everyone was overheating but all of a sudden at the bar while I was sweating & trying to pick up a drink order, my heart actually hurt me. I could feel it pounding, it was quite painful, as if someone was squeezing it. I wasn't short of breath but I did get quite lightheaded for a bit, felt like I was just going to pass out. I drank some water & sat down for awhile & slowly it went away. I also felt some discomfort on the left side of my neck & I'm not sure if I felt it in my left arm or if it was completely psychosematic & I just imagined these symptoms b/c I got so scared. Everyone told me I had a panic attack but it didn't feel that way to me. My boss even siad she's had panic attacks where her heart hurt her..... Believe me I've had my share of freak outs, & I feel that this was different. I know maybe it's ridiculous for a 26 yr old to think they've had a heart attack or is even in danger of having one,but I'm quite frightened. My mother had tachycardia from the time she was a small child until they did something to her heart a few yrs ago....I've asked my gp - it was about 2 years ago or so - to listen to my heart- told him I was having panic attacks but wanted to make sure my heart was ok, & he listened to it, said it was perfect, but ordered no tests. I'm not crazy, & I'm not a hypochondriac. Something is telling me something is not right. I even think I should take aspirin daily, not even sure that would prevent or help anything but at least it feels proactive. I know to start exercising more & my diet isn't too bad. I eat a lot of vegetables. I love fish...I think tomorrow I'll go to see another dr at my gp's office, a woman & run everything by her. I just don't want her to try & put me on meds for anxiety- if it's anxiety, fine I can talk myself down during a panic attack. I've learned how to do it over the years, a kind of "talking the jumper in off the ledge" sort of approach. I just don't want to be dismissed, b/c I think there may be something up with my heart- even if it's tachycardia or a "harmless" murmur or arrythmia. Any advice, especially from m.d.s would be greatly appreciated. I'm pretty upset & I don't know if I'm going to be able to sleep tonight. I'm pretty upset, I mean I have a little baby to take care of... I don't care if I'm laughed at, I jsut want some tests run.....

3:13 AM, May 26, 2006  
Anonymous Ickle m said...

This is my first day home from hospital, and after reading these posts, it makes me sad to hear that I'm NOT alone in my situation.

Six weeks ago I had symptoms of what I thought was a heart attack - the hospital treated me as a time waster (I have another undiagnosed disability) - they diagnosed me as having a chest infection - even though I had no symptoms of one, and the x-ray was clear. They sent ne home on antibiotics - still in pain.

Two weeks ago it happened again while I was a passenger in a car (with the same friend who'd been with me the first time). He took me home and asked what I wanted to do - thinking it was just the chest infection.
I was scared to call for an ambulance - and be treated as a time waster again, but I just knew I was going to die, so he rang 999 (I'm in England).

This time they seemed to take it more seriously, and I had the necessary tests done - to find out I was having my second heart attack, and had to be rushed by ambulance to a specialist hospital where I had an angioplasty, requiring 3 stents to be used (in my left anterior descending coronary artery) - this shocked my doctors, not just me!

I'm so confused and scared by this - I'll give you a bit of info about myself to explain a bit further:
My name is Em, I've never had any heart/lung problems, and I'm a 26 year old female...
My average blood pressure was noted as 100/60, my weight is 59Kg with a BMI of 21, my cholesterol was high at 6.4 - but they looked at my diet and couldn't find any changes I could make, so said it must be a family history of high cholesterol, so I'm just hoping the new tablets make a difference.

My risk factors are my lowered mobility due to my undiagnosed disability (mainly muscular spasms, nerve pain, and scoliosis), and I am a smoker;
I stopped smoking for a few days after the attack, but was taken off one of my main pain meds - so have been in hospital for an additional 2 weeks while they tried to control my pain (and didn't).
I've had to stop taking the contraceptive pill (and have been told I cannot use any form of it in replacement), my other main pain med has been drastically increased, and I've been put on 10 new different types of medication for my heart etc.

I have been under a lot of stress for the past year, but now I feel even more stressed, thinking that this could happen again at any time - and not understanding why it did in the first place.

I know the smoking is a risk factor, but I just can't see that I'm exactly high risk, especially at my age (I do intend to quit though, before anyone lectures me about that!! - I'm currently on about 5 a day, which I have when my pain gets really bad).

The one good thing that -might- come out of this is that there's a chance that this may have finally given the diagnosis for my disability (after 11 years) - although if it has, that's not good news either - but at least they'll stop treating me like a time waster.

Sorry for the long message - I'm just really confused, scared, and depressed right now - I hated being stuck in hospital, but being home by myself worries me.

If you made it this far, thanks for listening,
Em

9:30 PM, June 06, 2006  
Anonymous Anonymous said...

Hi. Thank you for sharing your story. I only wish I had seen it a few weeks ago. My little brother died of a heart attack on his 24th birthday after being misdiagnosed with panic disorder/attacks on several ER visits. God Bless you for the work you are doing.

Best Wishes- DK

10:37 PM, July 30, 2006  
Anonymous Anonymous said...

NEVER EVER GO BY Emergency Room STATING CRAP. I swear ER doctors are quacks, all of them.I think they look for the simple answer they want to see just to get you out the door. I had the same thing, they stated it was anxiety and it turned out to be a heart problem. 4 years later I still can't work though slowly I am getting better no thanks to the medical profession.

4:08 AM, July 31, 2006  
Blogger Helen said...

Ickle m, anonymous 10:37, and 4:08:

I realize your posts were written some time ago--I don't always follow up frequently on old posts. I just want to say how sorry I am for all of your heart related issues. Ickle, how scary, to think that the doctors took so long to find out what was wrong. I also, was on birth control pills and wonder if they played a role in my getting a blood clot. Doctors like to think they are safe and get annoyed if you say otherwise, but I think for some women, they are dangerous. Anonymous, 10:37, I am very sorry to hear about your brother--make sure that you get your heart checked out for any heart rhythm problems as they can run in families and finally, anonymous 4:08, not all emergency room docs are quacks but I agree that some are ridiculous and have the attention span of a gnat--one of mine did. That said, I have gotten great medical care with my current doctors and they pay more attention to my condition sometimes than I do. Search until you find a cardiologist you feel comfortable with and let them get to know your history etc. I am very glad you are getting better.

12:14 PM, August 02, 2006  
Blogger Graham Strouse said...

Em,

I'm on the other side of the Pond, but please don't hesitate to contact me. I'm on Blogger as you can see & am pretty easy to access by AIM.

I don't know what to say other then I look at my own situation and yours and I don't know that there's that much difference save for the details.

I'm 33, on my own & have had chronic, and expensive, health problems for years before things started to really go sideways. Losing a nut to cancer was part of it, but not the worst. Long story.

I hope you've got someone, or a collection of someones, to lean on. If you've got a side, consider it increased it increased by one. If not, well, now you do.

Contact me if you want or don't if you don't. And do feel free to Google my name if you're wondering which kind of crazy I am because, yeah, I know, people just don't say these things to strangers as a rule & maybe I'm the good kind of crazy.

People wonder about that a lot. i'm used to it. No worries.

I used to be a journalist & am a noisy Internet presence, VERY easy to find.

I'm a sympathetic era, an occasionally effective amateur advocate & a very good researcher. And I've got better then fair layman's knowledge of matters medical & access to people who have proper MDs. Makes me a decent information resource sometimes.

Don't you dare give up, Em.

Yrs,

Graham Strouse
Doylestown, PA
AIM: sinswages

4:46 PM, August 10, 2006  
Blogger Graham Strouse said...

I know my situation is a bit different from y'all's. The physical aspects of cardiac problems, I don't know anything about.

I do know what it's like to have an unfashionable medical problem that few people believe and no one wants to treat.

In some ways, the harder you fight your way back, the worse off you are. If you look good & seem normal, people just assume you're loafing when you step off for a nap or scale back your routine.

It's good to be married in these situations, at least if you've got a For Better or Worse partner who really meant it and means it.

Being isolated with cancer or a bad heart to keep you company is a scary proposition.

12:44 PM, August 17, 2006  
Blogger J. Peden said...

My God. I went to Medical School 1967-71, and ended up doing E.R. medicine for 28 years. I'm stunned by the quackery and minimization you experienced.

I was taught that symptoms of coronary artery disease are not gender-specific, and that they are myriad.

Anyone having the symptoms you had right from the start needs an EKG at the minimum, and immediately. Anything is possible and you must protect against the most dangerous the most, not try to simply write it off as something comforting and not very dangerous.

Merely your exact description of your initial episode is in fact classic for CAD. I'm not just making a 20-20 hindsight statement here.

Looking at it from another angle, an M.D. has to do the EKG, and then maybe more, in order to prove to the patient that it is not his/her heart, because this is what they are really worried about. But as an M.D., you also have to prove it to yourself. It's a big mistake to not prove it to yourself. It's also blatently lazy. EKG's are easy to do, and pretty easy to read. Then if you have to go further, so what?

Any person of any age can have chest pain and shortness of breath. Even if you know, as an M.D., that the symptoms are due to chest wall pain or hyperventilation, for example, you still have to do the EKG, then follow its lead.

Again, I'm stunned. But I have also seen in retirement at least two cases involving my friends where specialists totally botched the situation. In one case I actually saved my friend's life. He survived the treatment for a non-existent disease long enough to get off the treatment, which threatened to kill him. It was obvious to me from the start that he did not have the alleged disease.

You did.

5:09 PM, September 19, 2006  
Blogger J. Peden said...

A slight correction:"chest pain and shortness of breath", makes more sense to your case if said "chest pain or shortness of breath", although your description of your shortness of breath as suffocation accompanied by a sense of doom can be a kind of "pain".

Also, I wouldn't say a sense of doom is more specific to women, if only to forstall any random moron - thinking in reverse - from then needing to have a woman tell them she has or had a "sense of doom" in order to qualify for being at risk for CAD and death from it - or that men don't have it.

I almost get a kind of sense of doom listening to your story.

5:28 PM, September 19, 2006  
Anonymous angelo alonzo said...

Unfortunately your situaiton is all too common, especially among women. If others would like to share their care-seeking experiences they could go to hacs.osu.edu.

Angelo

3:15 PM, September 26, 2006  
Anonymous Anonymous said...

Thank you for posting your story, at times being a heart attack survivor at 34 years old is very lonely. I had a massive heart attack 6 months ago and have been deal with the effects of it. The most frustrating thing is I had seen a cardiologist before my heart attack becuase I was having palpations and after tests he said I was fine. I know now that I have severe heart disease and they missed it on the test they did before my heart attack. If only physicans would listen to their patients. I don't blame my docotor for the heart attack, that was my body but I do blame him for missing all the signs because I was a thin, 34 year old women.

Angel

9:23 AM, October 13, 2006  
Blogger Helen said...

Angel,

I am sorry to hear about your heart problems. It is very lonely having a heart attack at any age, but especially when one is younger, because no one seems to know much about it and don't really care. If you have breast cancer, you get all kinds of support, mainly because your boobs and "womanhood" are involved, not because of you as a person. I often got told I was lucky I did not have breast cancer--but a heart attack can actually be more debilitating on a daily basis but people do not understand that. I hope you get better--I did--listen to your doctors and insist on the best care.

7:21 AM, October 19, 2006  
Blogger Graham Strouse said...

Angel (everyone),

This is my current email address:

graham.strouse@yahoo.com

And this is my AIM ID:

sinswages

Angel, baby, you are not alone. And I will be hurt, horrifed & deeply offended if the bowers of the night start closing around you and you DON'T call.

A woman I wanted to spend the rest of my life with killed herself about 36 hours before my cancerous right testicle was removed. We loved each other fiercely. It wasn't enough. I don't blame her. I just mourn her.

What we have left, all us unfashionable victims, is each other. What we've got is what we've got. And what we've got is each other.

You know Narnia? The Garden of Ice?

You know the place where the recently-dead Aslan leads the sisters in the movie. And they have no idea why he's dragged them there until something clicks in Lucy's head--all these heroic fighters, frozen in ice...

And with them the lion whose roar is as the first light on the fifth day.

Angel, I don't pass out email & AIM identies just because. I do it because I believe it's important that all us unfashionable victims stick together.

See, the trick is, we fight together, then we're not so weak, nor so unfashionable.

And even if you just want someone to talk to a bit, that's fine. I'm not asking you to be the next Che Guevara.

But that's my email and my AIM identity.

It's an open com, kids.

You want to do me a favor, do yourselves a favor?

Hook up with me & help me with a strategy. What I want is a hand up, not a hand out.

You feeling me?

Does anyone here want to live life as a perpetual victim?

Right.

We've been kicked hard. But guess what?

WE ARE STILL HERE.

Now let's put aside the partisan nonsense & work together, 'kay?

Here's my deal:

Work with me, fight with me, defend me & accept my protection when you need it.

Why?

Because...because I know that if the situation is reversed, you will do the same for me.

I'm ripping from Pacino's run in "Any Given Sunday" at this point, but only because it's true.

That's my name. That's my AIM ID. If I'm offline I'll get online if y'all need or want communication or fire support.

I lost maybe the last woman I've known who might have said "Yes" & "I do."

That happens. But I will be damned if any of my girls are hurt because I was too timid or weak or cowardly to extend a hand.

I don't like my gals weak. I expect them to be strong. But I also expect them to be human. And human's break.

Human's break.

But we can fix ourselves, if we work and fight together.

Angel, baby, consider yourself one of my angels.

My middle name's even Charles, so you can be Charlie's Angel.

If something goes sideways, you contact me, you hear?

I mean it. I will be very angry if you die lonely & scared when you might have called me.

You hear?

We don't leave our people behind.

Period.

Angel, you've got an angel, a poor one perhaps, but don't hesitate to contact me if circumstances demand.

Please.

Graham Strouse
215 230 3836
graham.strouse@yahoo.com
fall_from_grace2001@yahoo.com
sinswages (AIM)
Sinjin_Thule (ID at Wizards of the Coast website)

I don't always pick up the phone unless I know whose calling, Angel. But the emails, I check. I'll illuminate the AIM ID for you.

Tomorrow morning. My word.

-G

5:45 PM, November 12, 2006  
Anonymous Anonymous said...

Hi,

First thanks for sharing your story, it's a good feeling to know some one out there knows how it feels to suffer a heart attack,
i suffered a heart attach at the age of 32 just after i had my daughter. she is 4 months old now, i am still depressed of the whole idea that i am a young mother and have to deal with a heart attack and take all the pills i take now.
after 4 visits to the doctor, two to the ER, and 2 to a cardiologist. they found out it was a heart attack ( attacks) that i was suffering and not a panic atack or stress from having a baby.

i'm still in the begening of the treatment, i still can't get it. how did this happen and why did it take that long for doctors to figure it out.
i'm just glad i'm here today, i'm glad my gaughter still has her mommy. you can't imagime how afraid it makes me feel to think i could have died, and left a baby behind. it breaks my heart.

i think i need time to understand what happened.
take care ladies,

Dina

8:39 AM, December 21, 2006  
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1:15 AM, December 25, 2006  
Anonymous susanm said...

When I was 41, a few years ago, I was laying down on the sofa, recovering from a hysterectomy when I became short of breath and felt like I was dieing. It felt like a ton of bricks on my chest. I called 911 and was taken to the hospital. They did a quick ekg and told me it was normal and that I had an anxiety attack. I just can't buy that. There was no reason for me to have an anxiety attack. But I believe the hormone patch I was wearing had a strange affect on me. It's so frustrating when Dr.s just blow you off.

11:25 PM, February 01, 2007  
Anonymous Anonymous said...

I am 26 years old female who is currently in UK from Asia. I have been suffering from chest pain and shortness of breath since last two years. It all started on one day when I was in office and my friend caught me by neck. I completely went dizzy and couldn’t breathe. I was immediately taken to the ER and done with all the heart related tests which came to be normal. I was then too scared and the episodes of shortness of breath kept on repeating. I was then taken to a Psychiatrist who said i was a panic attack patient. I was kept on treatment for almost 6 months but there was no improvement. Then I was taken to Gastroenterologist who said it looked like Reflux disease. He did endoscope and it came out to be Reflux disease with Hiatus hernia. He kept me on medicines which reduced the chest pain to certain extent but the breathing problems continue.
I have gone through lot many ECGs, two Eco-Cardiographs, and numerous Lipid tests. My lipid tests have indicated value of 3.2 to 3.3 of LDL. Is it normal or high?
I walk for 30 minutes every day and I m very active with weight of 50 kg and height of 5’6’’. Other tests have come normal and doctors say there is no problem with my heart.
But that doesn’t satisfy me as the breathless feeling is almost present every moment every day with chest pain. At times it becomes so unbearable that I cant walk a few steps also and start sweating or go cold, feel that I m going to faint down.

12:37 PM, April 10, 2007  
Anonymous Anonymous said...

Enjoyed a lot! » » »

6:32 AM, April 26, 2007  
Anonymous Diana said...

I was just released from the hospital this past Friday 4/27/07. I was admitted on Wednesday. My husband begged me to call the Dr. Wed. morning because for the 2nd morning in a row I was feeling a great amount of pressure in my chest. My neck had been stiff for the past 4 days and I had been very tired. The Dr's office told me to go to the emergency room. While in the emergency room I had and ekg which was normal and blood tests. While waiting for the results all the Dr's and nurses kept telling me I was too young (39) and they were sure it was something else causing my discomfort such as reflux. I have no family history of heart disease. I am not a smoker. I am not diabetic. I am not on B.c pills. I am not a crack user. Well the blood work came back and the slack jawed e.r. dr. told me my triponon levels were at 1.56 which indicates a heart attack. I had a ct scan...no clots. I had a Heart catherterzation...no clogs..I had an echogram. Everything was negative. No explanation for my symptoms. I was sent home with no restrictions, no meds, no answers. I'm happy my heart is healthy but I'm scared this will happen again. Does anyone know what opther routes I can take to find out what happened to me?

9:56 AM, May 01, 2007  
Blogger Dr. Rajeev Goyal said...

Hi
That was a good description of how heart attack may lead to misleading clinical picture, often delaying much wanted treatment. Conversly, it is also true that many people get treated for a heart attack when, infact they haven't had any.
For more information on chest pain and associated features pointing towards chest pain, visit
http://docrajeev.blogspot.com/

10:22 AM, June 21, 2007  
Anonymous Anonymous said...

Hi. I was doing some googling and came across this post. I'm 31 years old. Last year, at the age of 30, I had an MI. No sign of high cholesterol. Perfect lipid panel. No prior health problems. No family history. I just wanted to add to the discussion that it DOES happen to women under 40. It cannot be THAT rare. My cardiologist has a patient that is 29!! Anyway, one of the nightmares of my experience that seems to closely parallel yours is that I was told in the ER that I was having a panic attack and needed to
"calm down, honey." Despite my best efforts to "calm down"--nothing worked. Hours after two RELUCTANTLY given EKG'S came back abnormal, the doc shrugged and said, "I guess you were having a heart attack this afternoon." When I said, "Will I live?," he gave a cursory glance over his shoulder as he left the room and said "Probably." It was infuriating not to be taken seriously. And I didn't sue either. Like you, I'm just glad to be alive and functioning normally now.

4:20 PM, July 12, 2007  
Anonymous Heart Attack Jack said...

Thank you so much for writing. I myself am a 60-year-old male, who, after my second heart attack on Memorial Day, learned cardiovascular disease is progressive, and unless we change our lifestyles drastically, we will have more interventions/attacks in 5-7 after the last one. I'm writing a blog to try to inform people what they can do: basically, it comes down to "Work at Choosing Life" every day. The Ornish Lifestyle is one way to actually REVERSE heart disease and stenosis, but it is work. Wonderful work. Laughing at ourselves and not being afraid of death is a good thing too. I would welcome visitors to my site: heartbloggage.blogspot.com.

10:28 PM, July 19, 2007  
Blogger docskid said...

It's absolutely unforgivable that men should be given the best of care when presenting complaints of chest pain and women are treated as head cases- no matter what doctor you go to - it's always the same- I actually had a male doctor tell me that my glaucoma attack "was all in my head- and that I dreamed it" - my iop was 65 and I almost died from that attack- 90 % of docs are like this and the only way they change is is a female friend or wife has a heart problem- or death due to non-responsive ER docs. My own husband had a mild heart attack and the VA wouldn't see him to run a troponin test to see if his levels were going up- they told him to wait until his appt in 30 days- UNREAL- and sooo idiotic- teh best advise I can give is to make out your will and hope you get a decent er doc- if not- it's a toss of the coin whether you live or die.

5:18 PM, October 09, 2007  
Blogger kashley said...

The first few paragraphs of what I have to say/ask/comment may not seem relevant to this discussion, but please stick with me ...

I'll be 43 this weekend.

I've been taking Effexor XR for roughly five years for clinical depression and anxiety.

Before I began taking Effexor, I was healthy and slender and, though I'm still healthy, I've gained a significant amount of weight (I currently weigh 147 -- up from 107 pounds).

I've made several unsuccessful attempts to lose this weight including Nutri System and working out with a trainer for 2-3 hours a day, six days a week -- TO NO AVAIL. Not a single ounce lost and a barely-noticable change in my measurements (though my endurance did increase tremendously).

SO, I stopped trying to lose the weight two years ago. BUT, with yet another birthday looming, I decided to give it the old college try one last time.

Last week I had a physical (including EKG, blood pressure and bloodwork). With everything showing that I'm healthy -- the only concern being elevated cholestorol -- my doctor gave me the thumbs-up to begin an agressive diet and exercise program.

HERE is where the problem begins ...

I started working out with my trainer this past Friday (the same day I started a healthy diet). He's VERY concerned that I'm a heart-attack-waiting-to-happen. He constantly monitors my pulse/heartrate throughout my workout and my heartrate is consistently, RIDICULOUSLY high ...

At my max ability (where I feel great and loaded with energy) on any of his cardio-type exercise equipment (bike, eliptical, treadmill, etc.), my heartrate almost instantly rises to 180-190.

Needless to say, when my trainer sees my heartrate running that high, he immediately makes me slow down (to the point where I'm completely board to death with the exercise and don't feel like I'm getting a workout). While working out at this pace, my heartrate still stays in the 160-170 range.

Between exercises, my trainer has me take a long, slow walk around the gym. After five-or-so minutes, my heartrate goes down to anywhere between 125 and 135.

Even when I'm WELL-RESTED and before we even begin my workout, my heartrate is NEVER below 125. (Please note though that throughout all of this, my oxygen level remains at a very efficient level).

So ... what do I do???

Wouldn't/shouldn't anything amiss have shown up in any of the tests that my doctor did?

Do I need different tests?

Can my EFFEXOR XR be causing this increase in my heartrate?

Should I see my doctor or my psychiatrist (who proscribes the Effexor) about this? I don't want to pit one doctor against the other -- I'm scared to death of going off the Effexor because I don't want my depression/anxiety symptoms to return -- it's been working REALLY WELL and I'm scared that a different medication might not work as well or that I'll have to try a bunch of different meds over a long period of time before finding another one that keeps my depression/anxiety symptoms at bay.

THEN AGAIN, is it possible that the Effexor has absolutely nothing to do with my high heartrate? Would I have to go off the Effexor entirely to determine whether or not it's causing the problem -- not be on any meds while determining this???

Keeping in mind that I don't have health insurance and have to pay in cash, in full, for every doctor visit, test, etc., should I see my GP or my shrink regarding this???

What should I do???

4:27 PM, November 06, 2007  
Blogger Helen said...

Kashley,

I am a PHD, not an MD so it would be best to talk to your internist about the problems you are having. If you are concerned about your high heart rate, ask your internist or GP to let you wear a heart holter monitor for a few days while you exercise to see what is happening with your heart, if anything. This is how they caught my dangerous rhythm problems. Keep in mind though that if you are using the gym machines to keep track of your heart rate, they are often wrong. The holter monitor seems to work well for catching a fast or slow heart rate.

Take a look at this link for more on the holter monitor and what it does:

http://www.nlm.nih.gov/medlineplus/ency/article/003877.htm

9:07 AM, November 10, 2007  
Blogger kashley said...

Hey there Helen,

Thanks so much for your response -- and, actually, I will be addressing this issue with my GP this week.

But -- in addition to that, I guess my main reason for leaving a story/response on this blog in response to your story was the fact that you mentioned that you were taking Effexor. I'm very curious as to why you were taking it in the first place and why you asked your doctor to take you off of it.

9:46 AM, November 10, 2007  
Blogger Helen said...

Hi Kashley,

The Effexor did not cause or have anything to do with my heart attack--it was given to me after I had symptoms of shaking, panic and shortness of breath. The doctor thought I was having panic attacks and prescribed Effexor which is, as you probably know, an antidepressant that can help with anxiety. However,the medication made me worse as I was having heart arrythmmias, not panic attacks. The cause of my anxiety stemmed from my heart and once that was treated, the panic attacks cleared up. Effexor can be a fine drug for some people with depression and anxiety but that was not my problem at the time. Good luck talking with your GP. I hope you come up with some answers.

11:06 AM, November 13, 2007  
Blogger Schatsie said...

Dr. Helen,

Thank you for your article. I am 37, with unexplained shortness of breath and chest pain. Dr. has done EKG and checked oxygen level since both are normal, they are doubting me. Honestly, I'm starting to doubt myself. But the pressure has gotten to the point that I am too afraid to go to the gym. About a month ago I had what I thought was my first panic attack. It lasted about 2 hours. It was pretty intense. But even my husband doesn't know about it. This chest pain and shortness of breath has continued to get worse since that time. I started to cancel the appointments for further testing my Doctor scheduled, because I really was starting to believe this is just stress. I just figured I needed to tough it out and go back to the gym. No, I never told the doctors the "Panic Attack", either.

Thank you so much for sharing your story. Maybe I'll go for a few more tests, afterall.

4:33 PM, January 12, 2008  
Blogger Clay said...

Dear Dr. Helen,

Sorry to contact you this way, but I don't find an e-mail address on your site. I'm a writer compiling an anthology on heart disease. I'd like to propose reprinting your essay on your heart attack in the anthology. The publisher (Gale) will want to get in touch with you to secure reprint rights. If you are interested, would you please contact me?

Yours,

Clay Farris Naff
Member, National Association of Science Writers
Vice President, Nebraska Citizens for Science
Lincoln, NE
www.nebscience.org
claynaff@gmail.com

9:17 AM, January 19, 2008  
Blogger j. miri said...

Dr. Helen, thanks for sharing your experience with others. I wish to pass along a link to my blog and my experiences with coronary vascular disease. Thanks again.
J. Miri

http://iwasacardiaccripple.blogspot.com/2007/12/i-was-cardiac-cripple-life-in.html

1:07 PM, January 23, 2008  
Blogger Helen said...

Clay,

My email is on my blog on your right--just scroll down the home page but my email is drhelen at violentkids dot com

8:45 AM, January 25, 2008  
Blogger moonlake said...

I had not been feeling good for a while just tired and not too sure what was going on. I was only 37. Had a husband, three kids and a houseful of pets to take care of. I was never a very sick person always in pretty good health.

I was tired and some nights I would setup in bed trying to breath. My heart would also feel like it was jumping when I would lie down at night. My feet would swell.

In June our oldest son was graduating. I was busy getting the house ready for relatives coming and a graduating party. One morning I got out of bed and came up the stairs and my heart started beating in my neck very hard. I called the clinic and went in to see whatever doctor was there on a Saturday morning. He did an Electrocardiogram and told me it looked a little funny but was nothing. He gave me a prescription for Valium. I didn't take them because I didn't want to take them! Which was foolish they would have helped but they also would have covered up a big problem.

That fall I decided to go see my regular doctor and complained to him about everything I had been having trouble with. He sent me for an Echocardiogram. I waited, weeks went by and he never called me so I called him to find out what my test showed. He told me I had a few palpations learn to live with them and not to come back and see him with this problem. He made me mad and I decided I was done with doctors. I also thought this must all be in my head.

As the year went on I felt no better in fact worse. I would take naps when the kids were at school and I slept so hard it was like I had been someplace else when I woke up. I made it through winter and the next summer but when winter came again. I was really feeling bad by 4:00 in the afternoon I didn't have enough energy for to make dinner. My husband and kids would do it. My husband and I talked about what was going on with me and we even talked cancer. He tried to convince me to go to the doctor again but I couldn't not again.

Here are some of my symptoms, when I would get up in the morning I would feel out of breath and I would have a cold sweat. My ankles and feet would swell, my arm, fingers, and shoulder would hurt on my left side. The center of my back hurt all the time. The back of my neck hurt and my left jaw hurt, felt like a toothache. I was cold all the time I would go to bed with flannel gown, leggings, and my robe and still could not get warm. I would also set up in bed at night trying to breath, it was so bad I slept setting up. I was also very depressed. I had a feeling of impending doom. I even went through my things and told my husband what I wanted each child to have.

The first of December came and friends were going Christmas shopping and wanted me to go. I went and I felt fine when I left the house. It was cold that day about 20 degrees. When I would get out of the car my jaw would start to throb. I could barely make it into another store but once I was out of the cold and inside the pain went away. Even though I tried to hide it my friends realized I wasn't feeling good and headed for home early.

That night I had to sleep in a chair but when my husband woke me up I was feeling good. He had a fit and told me I had to call a doctor. I looked in the phone book and found a cardiology. Deep inside I knew it was my heart and not cancer. I got in right away even though the doctor wasn't there his physician assistant was there and I knew her. She told me to come in and she would check me. When I got to the doctors office and realized I was going to have to walk up a hill. I just about started to cry because I knew how hard that hill was going to be. When I walked into the doctor's office I was holding my chest and knew I was in trouble. All I remember was some lady jumped up and said "take her first."

They got me to the hospital. The doctor was there. The first thing he said to me was " This is not a heart attack, your to young, your cheeks are bright you look very healthy.." He put me in intensive care just to be safe; a few hours later they realized I had a heart attack. Three days later I had another one. They called my family said they didn't think I was going to make it. I was allergic to lots of the medications they put me on. As you can tell I made it. I was in the hospital one month. I missed Christmas and New Years. The first few years were terrible. I went to Mayo Clinic and they said they only saw one woman in 10 years my age with a heart attack. That was the old days when women didn't have heart attacks young now days they do. They never figured out why I had the heart attacks. I lost my left main artery from the attack. I do well now. Have a little trouble with, hills, cold weather, and humid weather. I have seen all my children grow up and have enjoyed grandchildren. I guess I'm a lucky woman.

Hope this helps anyone out there that is not feeling good. Don't be like me go to the doctor and if one won't listen go to another one until you find one that will listen. If I had recieved the care I needed right away I may have never had the heart attacks. If only they would have listened.

http://hubpages.com/hub/Wild-Animals-in-Our-Yard

9:25 PM, February 05, 2008  
Blogger Helen said...

Moonlake,

What a terrible story. I am surprised that doctors and other professionals refuse to get it through their head that women under 40 do have heart attacks and do not always look "unhealthy." I am so glad you got help and that you finally insisted on it. I think as heart attack survivors, it is up to us to help other women and men who have these problems. When I hear a professional go on about how women don't have heart attacks, I often talk with them directly and let them know that this is not the case, that they are being simplistic and that it is important to take women's complaints seriously. Our symptoms may be different, but they are as deadly as the symptoms men suffer from when they have a heart attack. It is important to take heart health seriously for both genders.

8:34 AM, February 10, 2008  
Blogger Kelly said...

I am 40. March the 8th I had a heart attack. I went in to the hospital thinking that I was having some kind of allergic reaction to a "Halls" cough drop I took for a very sore throat. I was panicked from not being able to breathe AND I have a history of anxiety attacks. Lucky for me it is POLICY in the hospital I went to here in rural Nova Scotia to run a quick ECG to make sure that the shortness of breath is not heart related. I got the clot-buster within 20 minutes of onset, and it saved my life. In the days that followed, I have had 2 stents put into my heart following a dye test. I am going to have to take it easy for a bit and change my lifestyle some (boy do I miss salt), but regardless of how "common" it is for premenopusal women to have heart problems, does it cost much to check??????

4:46 AM, March 13, 2008  
Blogger vadkins said...

My husband had a heart attack, from out of nowhere, at the age of 56. His cholesterol level was normal, and he has never smoked or drunk alcohol. We were shocked.

I am chronicaling the experience in part to crystallize the records in text, and that it may help others. I have included the narrative, the diagnosis, the hospital experiences, the test results. And I continue posting any new developments from his ongoing lab tests and appointments with his cardiologist. I will soon post his experience in cardiac rehab.

That blog is at www.qtmonster.com/attack

12:14 PM, April 21, 2008  
Blogger Diabetes Supply said...

At first, your blood sugar level may rise so slowly that you may not know that anything is wrong. One-third of all people who have diabetes do not know that they have the disease. If you do have Type 2 Diabetes Symptom, they may include: Feeling thirsty. Having to urinate more than usual, Feeling more hungry than usual, Losing weight without trying to. http://diets-diabetes.blogspot.com/

1:29 PM, July 24, 2008  
Blogger fandkhoffman said...

I read your story with interest. I am 40 and have always thought I'd die of cancer as my mother did. I will be more aware of heart issues now.

You mention a lowfat diet. Have you read anything about the link between heart disease and healthy saturate animal fats..also coconut oil and other tropical oils. There are links. Google the Weston A. Price Foundation for info. Of course, you may know this already!

Blessings!

Kristin

6:26 PM, August 05, 2008  
Blogger ParhamA said...

Female smokers who smoke from an early age run high risks of getting heart disorders. Infact the risks that they face are double as compared to their male counterparts. It has been proved that smoking yields much more adverse effects on women as compared to men. http://www.chantixhome.com

4:25 AM, August 22, 2008  
Blogger shadowfyre said...

Thank you for this note... I spent an afternoon in the doctors yesterday - chest pain, shortness of breath, shaking, and just feeling scared... now the irony is I have an enlarged left atrium and have been taught mental exercises to relax and have managed to control these feelings for years - so when the doctor said you are having an axiety attack and just listened with the stethescope and said dear just rest... I got upset... I demanded and EKG which she said showed an irregular heartbeat but nothing to worry was just anxiety attack and sent me home, the rest of the day I felt dreadful, just like I had been put through a wash cycle. Not sure what to do as she has basically decided she wont treat me for anything.

1:20 PM, October 04, 2008  
Blogger cottus said...

And yet there is no credible movement to displace the miserable AMA doctors from their elitist monopoly.

What if you felt free to follow your initial instincts? What if you could have then gone to a place and scheduled your own tests? What if you could have interviewed surgeons forced to provide basic information about price and service?

You have to fill in a few blanks in my scenario, but you must agree that the system now is broken, a supreme joke. Only you are ultimately responsible for your own health. The shackles that these quacks place on knowledge, service and cost is inimical to a free society and a free people.

You and your husband are members of elites, and sadly it is the nature of elites to preserve their territory, even though it may cost them their lives and the lives of millions of others.

1:18 PM, October 14, 2008  
Blogger Henry Fielding said...

A Cardiologist commented to me on your experience as follows:

Bet you a dollar that Helen has Lp(a) with small LDL particles, along with our old friend, vitamin D deficiency.

That is probably the most potent combination of plaque causes in otherwise healthy non-smoking, non-diabetics.


Way to find out if he is right is to get a "Lipoprotein Analysis" done to check your Lp(a) and your small LDL, plus a OH25D3 blood test to check your Vitamin D level

9:15 PM, October 14, 2008  
Blogger Helen said...

Henry Fielding,

Thanks for the suggestion. I think they ran those tests when I was sick. I was told that it was probably a combination of coronary spasm and a blood clot.

10:32 AM, November 04, 2008  
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此一未與學界、業界充分溝通即匆促制訂、且施行後成效不彰的室內設計管理辦法可說問題重重,值得深入檢討,以謀徹底改善之道。



  官方對於「室內設計」未能正確定位可說是問題的主要根源之一。此一瓶頸如無法突破,則室內設計將永遠只是附屬於建築底下的一個妾身未明、專業地位未受尊敬與肯定的灰色領域。這種情形對多年來努力建立室內設計專業教育體系的學界、以及辛勤接受室內設計各級專業教育的諸多莘莘學子而言,真是情何難堪。何以同樣在中華民國教育制度下,一樣的修業年限,一樣具備完整的專業教育體系,建築、土木等領域的畢業生就有機會取得官方對其專業地位的認定,其權利能受法律保障,而修習室內設計公司的室內設計者就只能參加建築物室內裝修專業技術人員之講習與測驗,還需在建築師、建築公會或其他相關專業團體之審核查驗下夾縫求生?這對室內設計領域是不公平的。如果不是其他專業領域之專業知識與技能未能完全涵蓋、不足以有效處理室內設計相關問題,何以有室內設計存在的空間?又何需大費周章建立從高中到研究所的專業教育體系?可見室內設計有其存在的必要與價值,也有其獨具的(與其他專業有所區隔的)專業知能。
再談談網站優化SEO方案的優勢和效果保證:




網路行銷管理顧問的專業實力決定了在網站優化方案及實施方面具有獨特的優勢,主要表現在下列方面:



領先的網路行銷導向網站建設理論和系統的網站優化思想指導;

作為中國中國互聯網協會網站建設指導規範的主要起草人,對網站規範(網站優化是網站規範的基本組成部分)的認識更為深刻;

對利用國際WEB標準實施網站重構有著豐富的經驗;

從網站運營策略層面進行整體網站優化,是網站運營導向的網站優化方案而不僅僅是為了搜尋引擎排名,單純的搜尋引擎排名效果是局部的、短暫的,也可能是後患無窮的;
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SEO不等於網站優化,不提供片面的SEO方案,實踐表明只有系統的網站優化才能達到最好的、持久的搜尋引擎優化效果;

基於用戶行為的研究,通過網站SEO優化為用戶提供最有價值的信息和服務,為瀏覽者轉化為顧客奠定基礎;

為眾多不同規模的企業網站及電子商務網站提供網站優化方案、實施及運營維護,豐富的網路行銷實踐經驗,讓網站優化深入到網站運營的每個細節,這是網站優化得以成功的基本保證。
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12:26 PM, April 29, 2009  
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9:41 AM, May 01, 2009  
Blogger rxbkd13 said...

成為大人好像會苦惱呢,媽媽因為公司的票貼被跳票,房子也被拿去二胎,我們家也被迫搬家,媽媽找了以前認識的搬家公司的叔叔幫我們搬東西,
那位叔叔現在是在基隆搬家公司工作,順便幫媽媽的忙,新家小小的,但媽媽希望有一定的生活品質,請了室內設計師來幫我們小小的家作規劃,原本小小的讓人覺得壓迫感很重的家,經過室內設計師和工人的巧手之後,變的很漂亮,照明也很充足,而且也有足夠的空間讓我畫畫,媽媽決定在這個家好好重新振作起來,先投資舅舅的gmp代工公司和姑姑做的噴霧乾燥機的製藥機械公司,媽媽自己則是要開一間小小的美容室,專為客人做去痘疤除毛和精油按摩,媽媽很辛苦,我也很想幫媽媽分擔一些事情,媽媽跟我說,電腦她一竅不通,不過聽說可以在網路上建立美容室的口碑很知名度,於是我就去網路上幫媽媽看看,有看到有人專門幫公司做網頁設計還有網路行銷,我想這應該就是媽媽想要的,就請他們幫媽媽打廣告,用了網頁和廣告之後,果然很有效,媽媽的客人越來越多了,媽媽很開心,我也很開心,因為賺了錢就可以把之前壞掉的車燈修好也可以買一把新的小雨傘,跟媽媽開開心心的出去玩囉

3:23 AM, May 04, 2009  
Blogger hualien said...

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10:15 AM, June 21, 2009  
Blogger Brate said...

Hey narayanan, you need to take care of your health. Its not an age of yours to have such a heart attack. Anyway my wishes are with you. Actually I had an experience of heart problem, but because of my initial care taken of the indications, I managed to prevent myself from anything severe. I was having fast heart beats, hard beating for some indefinite period of time. As I was somewhat aware of such palpitations, I immediately opted for some preliminary tests like Electrocardiogram and Echo cardiogram from www.elitehealth.com . It was quite satisfying that correct medication and proper guidance made me through all these problems. You can also find some very crucial information from http://www.elitehealth.com/heart_scans.php

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3:33 AM, July 17, 2009  
Blogger Laura said...

Hello my name is Laura,
I'm 34 years old about 2 months ago I was rushed to the ER with symptoms ranging from chest pain, dizzines, and nausea. I was released and told that I was suffering from anxiety/panic disorder and to visit my primary care physician. Well that's where all my problems began 2 months latter I'm still suffering from the same symptoms and even more the other night my lower legs hurted so bad that I almost woke my husband up and had him drive me to the ER once again. I also walk around with numbness and pain in arms. When I visited my primary care physician she never ran any test on me no EKG nothing just checked my heart with the stethoscope and sent me home with Xanax. I guess my question is what test should I be demanding that she do on me? I know it's not anxiety I'm not deppressed, suicidal, or over stressed well not up until now. Please help!!

1:21 PM, March 23, 2010  
Blogger dr.gregory b. harris said...

Dr. Helen,
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5:04 PM, January 19, 2011  
Blogger Jazzie Casas said...

Remember that time is an issue if you are experiencing one or several of the symptoms. The sooner a person seeks medical attention for symptoms of an impending heart attack, the more likely it is that the person will survive. Do not try to tough it out, or wait and hope that the discomfort that you are feeling will go away. There is never any harm in seeing the doctor, and having her tell you that you are fine. However, if you don’t see a physician, there is a fairly good chance that the heart attack will kill you. Don’t risk it.






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2:20 PM, February 03, 2011  
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9:43 PM, January 24, 2013  

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