I received an email message yesterday from an acquaintance I respect, so even though it was one of those "forwarded" messages I usually pay little or no attention to, one that asks you to forward to dozens of others (which I never do ordinarily) I decided to read this one carefully as it had been verified by a physician friend of hers. After reading it, I decided it was important enough that I should share it here in Elders Tribune in hopes it would reach as many women as possible. I was aware that female heart attacks are different, but this is the best description I've ever read.

The "forwarded email" message about women and heart attacks comes first, followed by the doctor's email verifying the contents.

Did you know that women rarely have the same dramatic symptoms that men have when experiencing heart attack...you know, the sudden stabbing pain in the chest, the cold sweat, grabbing the chest & dropping to the floor that we see in the movies. Here is the story of one woman's experience with a heart attack.

"I had a completely unexpected heart attack at about 10:30 pm with NO prior exertion, NO prior emotional trauma that one would suspect might've brought it on. I was sitting all snugly & warm on a cold evening, with my purring cat in my lap, reading an interesting story my friend had sent me, and actually thinking,"A-A-h, this is the life, all cozy and warm in my soft, cushy Lazy Boy with my feet propped up." A moment later, I felt that awful sensation of indigestion, when you've been in a hurry and grabbed a bite of sandwich and washed it down with a dash of water, and that hurried bite seems to feel like you've swallowed a golf ball going down the esophagus in slow motion and it is most uncomfortable. You realize you shouldn't have gulped it down so fast and needed to chew it more thoroughly and this time drink a glass of water to hasten its progress down to the s stomach. This was my initial sensation---the only trouble was that I hadn't taken a bite of anything since about 5:00 p.m.

"After that had seemed to subside, the next sensation was like little squeezing motions that seemed to be racing up my SPINE (hind-sight, it was probably my aorta spasming), gaining speed as they continued racing up and under my sternum (breast bone, where one presses rhythmically when administering CPR). This fascinating process continued on into my throat and branched out into both jaws.

"AHA!! NOW I stopped puzzling about what was happening--we all have read and/or heard about pain in the jaws being one of the signals of an MI happening, haven't we? I said aloud to myself and the cat, "Dear God, I think I'm having a heart attack !" I lowered the foot rest, dumping the cat from my lap, started to take a step and fell on the floor instead. I thought to myself "If this is a heart attack, I shouldn't be walking into the next room where the phone is or anywhere else .......but, on the other hand, if I don't, nobody will know that I need help, and if I wait any longer I may not be able to get up in moment."

"I pulled myself up with the arms of the chair, walked slowly into the next room and dialed the Paramedics... I told her I thought I was having a heart attack due to the pressure building under the sternum and radiating into my jaws. I didn't feel hysterical or afraid, just stating the facts.

She said she was sending the Paramedics over mmediately, asked if the front door was near to me, and if so, to unbolt the door and then lie down on the floor where they could see me when they came in.

"I then laid down on the floor as instructed and lost consciousness, as I don't remember the medics coming in, their examination, lifting me onto a gurney or getting me into their ambulance, or hearing the call they made to St. Jude ER on the way, but I did briefly awaken when we arrived and saw that the Cardiologist was already there in his surgical blues and cap, helping the medics pull my stretcher out of the ambulance. He was bending over me asking questions (probably something like "Have you taken any medications?") but I couldn't make my mind interpret what he was saying, or form an answer, and nodded off again, not waking up until the Cardiologist and partner had already threaded the teeny angiogram balloon up my femoral artery into the aorta and into my heart where they installed 2 side by side stints to hold open my right coronary artery.

"I know it sounds like all my thinking and actions at home must have taken at least 20-30 minutes before calling the Paramedics, but actually it took perhaps 4-5 minutes before the call, and both the fire station and St. Jude are only minutes away from my home, and my Cardiologist was already to go to the OR in his scrubs and get going on restarting my heart (which had stopped somewhere between my arrival and the procedure) and installing the stints.

"Why have I written all of this to you with so much detail? Because I want all of you who are so important in my life to know what I learned first hand."

1. Be aware that something very different is happening in your body not the usual men's symptoms, but inexplicable things happening (until my sternum and jaws got into the act ). It is said that many more women than men die of their first (and last) MI because they didn't know they were having one, and commonly mistake it as indigestion, take some Maalox or other anti-heartburn preparation, and go to bed, hoping they'll feel better in the morning when they wake up....which doesn't happen. My female friends, your symptoms might not be exactly like mine, so I advise you to call the Paramedics if ANYTHING is unpleasantly happening that you've not felt before. It is better to have a "false alarm" visitation than to risk your life guessing what it might be!

2. Note that I said "Call the Paramedics".

Ladies, TIME IS OF THE ESSENCE! Do NOT try to drive yourself to the ER--you're a hazard to others on the road, and so is your panicked husband who will be speeding and looking
anxiously at what's happening with you instead of the road. Do NOT call your doctor--he doesn't know where you live and if it's at night you won't reach him anyway, and if it's daytime, his assistants (or answering service) will tell you to call the Paramedics. He doesn't carry the equipment in his car that you need to be saved! The paramedics do, principally OXYGEN that you need ASAP. Your Dr. will be notified later.

3. Don't assume it couldn't be a heart attack because you have a normal cholesterol count

Research has discovered that a cholesterol elevated reading is rarely the cause of an MI (unless it's unbelievably high, and/or accompanied by high blood pressure.) MI's are usually caused by long-term stress and inflammation in the body, which dumps all sorts of deadly hormones into your system to sludge things up in there. Pain in the jaw can wake you from a sound sleep. Let's be careful and be aware. The more we know, the better chance we could survive...

Doctor's email reply

This is John replying. I agree with everything the lady said and then some. Her pain did become classical with radiation to the jaw; but even with the stomach symptoms (sudden and not related to what she had been eating) and the back should be evaluated at the Emergency Room. Women frequently do not have fist like chest pain or radiation to the arm or jaw. And the pain in the back could be any number of other critical problems like aortic aneurysm, Mesenteric artery infarction, or something in the spine.

We don't usually participate in chain letters, but this is an important message and they are not asking for money for Nigeria, so go ahead and send it.

John M. Tudor, Jr., M.D., Murray, Utah