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Sunday, November 26, 2023

I thought I was having an anxiety attack. It was a ‘widowmaker.’

“The classic symptoms of a heart attack are chest pain and pressure, but they’re not the only red flags

(Elizabeth von Oehsen/The Washington Post)

My best friend is a retired emergency room doctor, and he has seen it all. Yet when I met him for a weekend walk recently and told him I wasn’t feeling well, he and I both attributed my symptoms to anxiety.

In reality, I was having a heart attack.

The classic symptoms of a heart attack are “chest pain and pressure that radiates to the left arm and jaw,” Grant Reed, an interventional cardiologist at the Cleveland Clinic, later told me. But they’re not the only symptoms.

Mark Shavin with his doctor friend, left, back at the park 19 days after their walk was cut short by Shavin's heart attack. (Mark Shavin)

“People can experience a range of symptoms that also include shortness of breath, sweating, nausea and other symptoms. Females and diabetics can have many of the symptoms other than discomfort,” Reed said.

That was the case for me. On that recent fateful weekend, I told my friend I was anxious, attributing it to stress about my elderly mother’s health. My breathing also felt shallow, and my left arm was numb. But I didn’t have chest pain or pressure, nor was pain shooting down my arm.

As we began our walk through a park, my friend checked my pulse repeatedly. It was steady, and he recommended measured breaths to help me relax. I did as he instructed, but as we continued our walk, I couldn’t get a deep breath. And after walking half a mile, I had to stop.

“We need to go to the hospital and have this checked out,” my friend said. We turned around to walk back to where we parked, and I called my wife. After a few minutes, I had to stop again. Then, my friend noticed I was sweating profusely. That tripped his alarm.

Mark Shavin and his wife two days after an unexpected rush to the emergency room. (Mark Shavin)

I’m 66 years old, and 12 years ago, I had my first wake-up call when my doctor spotted an anomaly on a treadmill test during my routine physical. Subsequently, a cardiologist placed two stents, or mesh coils, inside my arteries to keep them open and improve blood flow.

Walking has always been a respite for me, and for 15 years I’ve met my doctor buddy once a week for a stroll. But on the day of my heart attack, I knew something wasn’t right.

As my symptoms worsened, my friend offered to summon an ambulance or to drive me to the hospital, but I was afraid to be alone while he went to get his car. I texted my wife, and she arrived within minutes and rushed me to the emergency room, only four miles away. My friend called ahead to alert them that I was coming, and yet, when I walked unsteadily into the hospital, the staff sat me down in a wheelchair in a line behind four other people.

“I’m having an emergency,” I said to a passing attendant.

“Everyone here is having an emergency,” he said and kept walking.

“You’ve got to get me help,” I told my wife, as my voice and breathing grew weaker. She flew into action.

The next thing I knew, the emergency room staff was slapping a defibrillator pad on my back. Someone gave me an aspirin with a sip of water. Someone else put a nitroglycerin tablet under my tongue. They pulled off my shirt and started to unfasten my shorts. I grabbed at my underwear, clinging to a shred of modesty, but was rebuffed. “Everything’s coming off, sir.”

Moments later, an electrocardiogram revealed I was having a heart attack, and a nurse and an orderly propelled me on a stretcher down a series of hallways — ceiling lights flashing by at breakneck speed — to the cardiac catheterization lab, where imaging of my arteries revealed the total blockage of one of my previous stents. A cardiologist cleared the obstruction and inserted a new stent inside the old one.

All of this happened on a Saturday. While still recovering in the cath lab, 15 minutes after my procedure, I asked the cardiologist, who had just saved my life, if I could go back to teaching my college journalism classes on Monday. He was incredulous.

“Don’t you understand you’ve had a heart attack?”

I didn’t. Nor did my wife until that moment. In fact, it turned out I’d had a so-called widowmaker heart attack, in which the largest artery in the heart — the left anterior descending artery — is blocked. That artery provides 50 percent of the heart muscle’s blood supply, and “a widowmaker is immediately life-threatening,” the Cleveland Clinic says. Mine was 100 percent obstructed.

Cardiac arrest — when the heart stops — kills 300,000 to 450,000 people in the United States annually, according to the National Heart, Lung and Blood Institute. Reed told me later that the obstruction in my artery could have been fatal had my heart stopped, but that I was lucky.

“You also paid attention to your symptoms and were with someone who helped you get prompt medical attention,” he said. “Some people either do not pay attention or don’t know enough to recognize the symptoms could be a heart attack and come in hours into their heart attack.”

In that case, Reed said, a lot of damage may already be done: “Heart muscle function may not be restored even when you open up the artery. It’s important to seek medical attention early to keep the heart from being permanently injured. We say, ‘Time is muscle,’” he added.

Reed and my friend both noted that panic attacks often mimic heart attacks. Shortness of breath is common to both. Typically, though, panic attacks resolve in about 10 minutes, Reed said. “Definitely seek medical attention if your symptoms do not resolve quickly. … The consequences of missing a heart attack can be very severe.”

“I think the only lesson to be learned is, if there is any doubt, have it checked out,” said my friend.

I am lucky to be alive — lucky, too, to have a devoted wife who rushed me to the hospital and, through her tears, reassured our three children that I was okay. I am grateful to have a caring friend who sat with my wife in the hospital from the moment I was admitted.

After a few days, I left the hospital with a damaged but grateful heart. But before my wife drove me home, I asked her to drive me back to the park. I needed to see the spot where my life almost ended. I needed to feel that eventually I could resume the healthy habits of my old life.

I know I need to make changes, particularly to reduce my stress. I have started cardiac rehab, but I am also tending to my emotional well-being, the bouts of sadness, even despair, that are common after a heart attack. I am looking at my life through a new lens, working hard to visualize a future that feels hopeful and worthy of the second chance I have been granted. I have a long road ahead of me, but I won’t have to walk it alone.

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