Heart attacks. Often deadly, they can be loud or they can be silent. But how would you know if you are having a heart attack? In the movies or on TV generally, they show heart attacks to be very dramatic; the person clutches their chest in pain and they often fall to the ground. However, in real life, heart attacks are often not as dramatic. In fact, you can have a heart attack without knowing it. This is what makes heart attacks so deadly because if you know you’re having a heart attack then you’ll seek treatment for it and if you get to the hospital in time, you could be saved. Therefore, it is important that we all be able to spot the symptoms of a heart attack. But this, in itself, is another problem. The classic heart attack symptoms – chest pain, with pain radiating to the arms, back, upper abdomen and jaw – are often found in males, i.e. females are more likely to have atypical symptoms such as shortness of breath, weakness, and fatigue. Due to the atypical nature of heart attack symptoms in women, women are less likely to seek treatment for heart attacks than men, and even when they do, their symptoms are often dismissed. Different studies have also shown that women receive worse care after heart attacks than men. In fact, heart disease causes more deaths among women than all cancers combined, making it the No. 1 killer of women worldwide! With this stunning revelation, I decided to seek out women who have had heart attacks to ask them what their symptoms were and their whole experience of it. I talked with Sarah Larlar Fisher, Harley, Chassity Bynum, Tracie, Kai Moche, Lisabeth Cascio Esposito, Dorie Davis, and Leanne Simpson.
Sarah: I had a heart attack in Nov 2014 & emergency angioplasty procedure (LAD 70-90% - severe stenosis - stents fitted). My symptoms began (I think) two weeks earlier - shortness of breath, nausea, back and jaw pain, chest discomfort, mild flu like symptoms. I rang emergency, but the doctor told me over phone that I was too young for a heart attack – I was 43 – and later that day I was admitted to hospital. I spent a week in the cardiac unit, and then 16 weeks at cardio rehab (weekly sessions at local hospital).
RC: What made you suspect it was a heart attack? I mean, those symptoms could be anything really, which is what prevents most people from seeking emergency treatment. What would say was the 'AHA' moment?
Sarah: My husband is a trained first aider - he recognised my symptoms and literally saved my life. An ECG was done at my doctor’s and then I went straight to the emergency room by ambulance.
RC: Oh wow. That's really lucky. I think I should take a course in basic first aid then. Do you think everyone should be required to learn basic first aid?
Sarah: I think it should be mandatory.
Harley: Two days prior to my heart attack on April 5th I had from ear to ear lower jaw excruciating pain that lasted for just seconds and went completely away. Two days later I was having heart palpitations all day that I just figured was stress and I took a Xanax and laid down. Two hours later the palpitations were still going strong and when I stood up I was instantly dizzy and nauseous. I immediately thought to look up the signs of a heart attack for a woman. As soon as I saw the jaw pain I thought better safe than sorry. I was at first going to lay back down but went to ER instead. Sure enough, it was a mild stress heart attack. Cath lab the next day, no stents, no blockages, no coronary heart disease. Two weeks later, I was having irregular heartbeats, I went to the doctor and wore a heart monitor. I was having more than double the heartbeats in an hour than normal. Now I’m on two medicines to control rapid heartbeat and skips.
RC: When you went to the ER, did you just announce that you thought you were having a heart attack or what did you do?
Harley: I said I think I am having a heart attack, told them my symptoms and they immediately took me back. My husband is also a heart attack survivor. He had five stents put in.
RC: What were his symptoms?
Harley: Left arm pain, nausea, light-headedness, typical chest pain and sweating.
Chassity: I acquired peripartum cardiomyopathy (PPCM), a disease of the heart that can develop in some women in the third trimester of pregnancy. I was 33 when I had my heart attack, just days after giving birth. I had shortness of breath and a numbness in my left arm. It felt like an elephant literally was sitting on my chest. Imagine that! I’m blessed that my hubby of 15 years called 911 because he saved my life. When they got to our home they informed him that I was having a heart attack.
Tracey: I experienced a heart attack nearly two years ago. Felt like terrible heartburn running up my left arm and in my back and belly. I worked out three times that day to shake the feeling. 14 hours later, I went to Target to get aspirin and tums and shared my symptoms with the pharmacist who advised me to immediately go to ER. Thank God for him. ER confirmed I was having a heart attack and it was a whirlwind from there. I had experienced a coronary artery dissection. We do not know what caused my artery to tear. I have a stent but no plaque in my arteries and no form of heart disease.
Kai: I actually did not have the typical symptoms because I had SCAD, spontaneous coronary artery dissection. SCAD is not well understood and is still being researched. I was working out and I experienced nausea and heartburn. My son got me to the hospital in time. However, according to the EKG and X-Ray, I was fine. The doctors were getting ready to release me but another doctor requested blood work and my blood work showed my Troponin levels were higher than normal which meant I had had a heart attack. When the doctors realized I had had a heart attack although I did not have a family history of heart disease or health risk factors, a cardiac catheterization was done and the surgeon saw that two arteries had dissected. My left anterior descending (LAD) artery was the worst of the two. My arteries looked as if a pair of scissors had taken to them. When I woke up in the ICU, I didn’t know what had happened and I was confused because I am a physically fit woman and I have always watched and weighed my food etc. Anyway, I am beyond grateful to be here, almost 5 years later on June 29th.
Lisabeth: I also have SCAD pain in the chest. I have had 5 heart attacks, 4 stents, triple bypass all within these past 6 months.
Dorie: I was having a heart attack for 2 weeks. I first noticed shortness of breath going upstairs and fatigue. I was having trouble sleeping. I had extreme neck pain that I thought was because I had pulled a muscle as I was still teaching step aerobics 2 days per week during that time as well. I went home early on Friday feeling awful just thinking I was coming down with a cold. Saturday night was bad and by Sunday morning my fiancé insisted taking me to urgent care as I was going to wait till Monday to see a doctor. He took me to the emergency instead for some reason and I told them I was not feeling well. They put me on an EKG and from there they could not undress me fast enough and before I knew it, I was on a bed being wheeled to OR. I was told I was 100% blocked and two stents later and couple of days in ICU was sent home with now 7 different meds that should prevent me from having another heart attack. I cannot stress enough to listen to your body. I was told with my condition that 90% usually do not make it. So grateful I was in that 10% and that all the step classes and soccer helped keep me alive as I was relatively healthy. Heredity and stress were the culprits for my heart attack.
Leanne: I have had stress (environmental and physical) related high blood pressure since 2007 when I was diagnosed with PIH – pregnancy-induced hypertension. My blood pressure was 209/190. An emergency was first induced when my first son was born. May 16/17th 10pm – 4.38am, I had my first known heart attack. Working with a cardiologist, we moved to determine if that was really my first. I had been doing pilates and yoga that night (I had been feeling too sick for Zumba, as I have issues with PCOS and endometriosis and I was having my period). Halfway through my workout, I felt super dizzy, a dizziness and light-headedness I couldn’t shake with my normal methods. So I did my cooldown and stood up a little bit and paced. Then I felt like a horse had kicked me in the chest. I couldn’t breathe. I couldn’t catch my breath. Then I felt a squeezing sensation (like Braxton-Hicks contraction of the uterus, but in my heart instead). It happened over and over and over again and hurt worse and worse. Then I screamed out when I caught my breath. Now I am recovering. I have a weird new heart rate to get used to. I’m starting to do my workouts again, slowly easing into them. But when my heart hurts and I can feel the burning I cool down and stop. I’m hoping to get back to my Zumba classes soon as we are moving to a new location and that’s my job. I monitor my BP everyday and it’s been back to 120/80 which is amazing.
RC: Did you take yourself to the hospital or did someone else take you?
Leanne: Someone else. I didn’t know what to do. As far as I was concerned, I was perfectly healthy and an athlete.
RC: Did PCOS and/or endometriosis play any role in your heart attack?
Leanne: It’s possible. I found out that the heart attack had to do with bradycardia (hypotension) problems and not my normal ventricular tachycardia or hypertension. So it may very well have to do with the fact I was menstruating with my endometriosis and PCOS.
So, what should you do if you suspect you're having a heart attack? Doctors all agree on the better safe than sorry approach, i.e. get checked out anyway. You'd better get checked out and it turns out to not be a heart attack than you not get checked out and it turns out it was a heart attack. Call an ambulance if you can and get to the hospital as soon as possible. Aspirin is an appropriate treatment for a suspected heart attack because it is an anticoagulant i.e. it clears clots, so you can take an aspirin if you suspect you're having a heart attack. If you do take an aspirin, tell the doctors/emergency response team. If you can't take aspirin, for example due to allergies or gastrointestinal bleeding, DON'T take the aspirin. If you have nitroglycerin (prescription only), take it. DON'T take someone else's nitroglycerin as that could put you in more danger. If you're with a person who collapses, begin CPR. If you don't have CPR training, just do chest compressions.
It is also important to know the risk factors. High blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, and excessive alcohol intake are amongst the risk factors for heart attacks. However, as we've seen, some heart attacks can be due to genetics and even stress. Others, like SCAD, affect even the healthiest of individuals (especially young women), a phenomenon that has really confused medics. The risk factors that you can control, it is advisable you take control of them and make the appropriate lifestyle changes.
All in all, heart attacks can be fatal, but creating awareness improves the recovery rates and prognosis by simple things such as ensuring people know the symptoms, that they can get to the hospital in time, and that they are not dismissed.
Emergency numbers in Kenya:
Kenya Police Hotlines
999, 112, 911
Fire and Ambulance Services
020-2222181/ 020-2222182/ 020-2344599
Kenyatta National Hospital
Use these numbers to call:
020 2726300 -11
Kenyatta National Hospital
Disaster management command center: 020 2115953
Labour ward: 020 271151
Aga Khan University Hospital, Nairobi
3rd Parklands Avenue, Limuru Road, Nairobi, Kenya
Phone: +254 (0) 20 366 2000
The Mathare Hospital
Embu - Nairobi Hwy, Nairobi, Kenya
Tel: +254-202337694 Mobile: +254-721336017
Kenya Red Cross
South C, RedCross Road, Off Popo Road
P.O. Box. 40712, 00100
Tel: +254 02 3950000
Cell (1): +254 703 037000
Cell (2): +254 722 206958
Cell (3): +254 733 333041
Toll Free HOTLINE: 1199
St. John's Ambulance
N.B. St. John's Ambulance offers free evacuations for all emergency and disasters like road crash, fire, collapsed building, and terror attacks and for life-threatening emergency medical conditions e.g. in case of unconsciousness, blocked airway (choking), difficulty breathing and severe bleeding.