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THE HEALTHY MAN

Heart Attack: Is That Chest Pain the Real Thing?

April 10, 2000|Timothy Gower

Certain dates stick in your memory. One I may never forget is Dec. 15, 1998. That was the night I didn't have a heart attack, though you could have fooled me for a few hours that evening.

I had just lugged a Christmas tree from the trunk of my car to our backyard, where I planned to leave it until the next day. As I leaned over to set the tree down on the patio, I felt a pain in my chest. A rush of thoughts hit me, none terribly happy. I ignored them.

Not for long, though. I went in the house, but for the next 15 minutes my chest felt like it was splitting in two every time I moved my upper body. Finally, after a loud gasp, my wife rushed in from the next room. She found me clutching my chest and looking like I'd just tangoed with the Grim Reaper. The debate began: Do we go to the emergency room or not? I hesitated. What if it's not a heart attack? Will the ER doctors and nurses think I'm a weenie for wasting their time? My wife eventually convinced me that we should play it safe, and off we went.

Thinking that you're having a heart attack isn't much fun, but it does have an upside: You automatically move to the head of the line at the ER. A young doctor ordered a series of tests, but they were all negative. He shrugged and sent us home. By that time, the pain had begun to fade. The only lingering problem was that my wife missed that night's episode of "Felicity," leaving her wondering whether the TV show's waifish heroine was in love with Ben or Noah.

Ever since that night, though, a question has nagged me. Was I a weenie for going to the hospital, taking the time and energy of ER staff who could have been treating other patients?

So I told my story to Dr. Nieca Goldberg, a cardiologist at Lenox Hill Hospital in New York City and a spokeswoman for the American Heart Assn. She reassured me that I hadn't wasted anyone's time. "It's always better to go get something checked out than to stay at home and find out you're in really bad shape," she says.

Had Goldberg been at my house that night, however, she might have saved us a trip to the hospital. The dead giveaway that I wasn't having a heart attack, pardon the pun, was that my chest only hurt when I moved. "The pain associated with a heart attack doesn't respond to movement," she says. She adds that muscle strain from weightlifting or stretching can cause chest pain that often masquerades as a heart attack. And, sure enough, I had done some vigorous stretching exercises that morning.

Here's what an actual heart attack typically feels like, according to Goldberg. The classic symptom is, of course, chest pain. But while my pain felt like (and probably was) a pulled muscle, most heart attack victims describe a crushing sensation, like a rope being drawn tightly across their upper torso. "Or like someone is sitting on them," Goldberg says. The pain lasts for more than a few minutes, though it may go away briefly, then return. It may also spread to one or both arms, or to your jaw.

No one knows why, but men are more likely than women to experience crushing chest pain, says Goldberg. That's why, contrary to our reputation for macho denial, men actually make the decision to seek medical attention sooner than women do, on average, since the main symptom is more obvious. (Women are more likely to confuse the early symptoms of a heart attack with some other ailment, such as back pain or stomachache.)

The chest pain associated with heart attacks is often accompanied by paleness, sweating, lightheadedness, nausea or shortness of breath. If you have any combination of these symptoms, call 911. Letting a loved one or friend drive you to an ER is dicey, since they might panic and cause an accident. More importantly, paramedics can start treating you en route to the hospital.

Goldberg offers a final note about chest pain. If it comes on during exercise but disappears when you stop, make an appointment to see your physician--soon. You may have angina pectoris, which means your heart isn't getting enough oxygen, possibly because your arteries are clogged with gunk, which could lead to a heart attack. If the pain is severe and persistent, call 911 or get yourself directly to an ER.

Goldberg is also quick to note that there's plenty you can do to avoid becoming one of the 1.5 million Americans who has a heart attack each year. Exercise, stay trim, keep your cholesterol and blood pressure down and don't smoke. Trust me, there are better ways to spend an evening than lying on a gurney in an ER. Even if it means watching "Felicity."

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Timothy Gower is the author of "Staying at the Top of Your Game" (Avon Books, 1999). He can be reached at tgower@capecod.net. The Healthy Man runs the second Monday of the month.

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