Heart attack symptoms can be subtle, elusive

Wednesday, August 3, 2011
Mark Stark of Holiday Island, above, says Carolyn Gentry, owner of Island Health & Fitness sent him to the hospital when she clued in that his symptoms and just not feeling "normal" could be signs of an impending heart attack. Sure enough, he came "within a hair's breadth" of having one. He had stents put in. Stark is just one of five people Gentry sent for tests recently, who all ended up needing heart treatment.

HOLIDAY ISLAND -- When is a toothache a heart attack?

When it's not really a toothache.

Carolyn Gentry, owner of Island Health & Fitness, said she has sent five people to the hospital in the last couple months with what turned out to be impending heart attacks -- and they all ended up getting stents.

Gentry, an R.N. who works at St. John's Hospital-Berryville filling in where needed and who was the former cardiac rehabilitation manager, knows what she's talking about.

"Everyone knows if it's horrible pain, but if it's milder, it's hard to make that call," she said. "It could be anywhere on your upper body, and it could be your heart."

She said pains could be in the arms, stomach, even the jaw or upper back.

"We've had people come into the ER who thought they were having a toothache, and it was their heart."

The only way to know for sure, she said, is to go to a doctor or the emergency room.

"When a person comes into the ER, we check out their heart -- draw blood, take an EKG and put them on a heart monitor."

Mark Stark of Holiday Island was one of the people Gentry sent to the hospital.

"She saved my life," he said frankly.

"Mark was having chest pain that was really mild," Gentry said. "Mark has atypical symptoms, but what clued me in was he was having them for a couple weeks. He said he didn't feel well and didn't feel like exercising."

Stark is 65 and said he's been living with chest pains for years. He is a Vietnam veteran who said his heart problems, and later lung cancer, were attributed to Agent Orange. He had a double bypass in 2008.

It was the Saturday before Valentine's Day when Stark came to the fitness center and didn't feel like exercising.

"The day I came in, I just didn't feel normal. I didn't want to take that next step," he said.

He told his wife, Gretchen, he didn't want to worry her, but had been having chest pains for two weeks.

"I said, 'You're going to the hospital today,'" Carolyn said.

Stark went first to Eureka Springs Hospital and then to Washington Regional.

"I had an angiogram. The doctor said I came within a hair's breadth of having a heart attack," Stark said.

They put stents in his arteries. He still has the chest pains almost daily, which puzzles doctors, because they say his heart is in good shape, even with the bypass.

He takes nitroglycerin to dilate his blood vessels and increase blood flow when he has a problem. He has been through cardiac rehab at St. John's.

Gentry said other people she has sent to the hospital have had "odd" symptoms.

"One guy had acid reflux and had had it before," she said. "He developed it while on the treadmill, and then it went away after he stopped exercising. That's a red flag."

One man had a physical exam and checked out fine the week before his heart problem.

Another man got off the treadmill and said he was having chest pain. He had had it before, but it had always "worked itself through."

"I had to put oxygen on him to make it go away," she said. "If something like that relieves it, it's your heart."

Yet another man was having problems with blood pressure, and a woman was having problems with high blood pressure and low heart rate. She ended up with a pacemaker.

Heart attacks are caused by clogged arteries, Gentry said. You can be fine one day and have a problem the next.

She said women tend to have different symptoms that are not immediately attributed to heart trouble.

"Women diabetics and the elderly tend to have atypical chest pain, so it's easy to miss," Gentry said. "In the past, women were misdiagnosed because they weren't taken seriously."

Any pain in the upper body could be heart-related.

"It could be discomfort or a feeling of fullness or tightness, pressure, a dull ache or even feel like a gall bladder attack. Listen to your body, and if something's different, there's probably a reason."

She said she doesn't want to alarm people and send them to the doctor with every little symptom, but if there is a symptom, accompanied by another symptom, it should be checked out.

"The only absolute test is an angiogram," she said, "but doctors won't order it without symptoms."

If you go to the doctor or the ER, they'll ask for a history of heart problems in you or your family in the early years, the 50s.

"Heredity is getting to be very important," she said.

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