En español | More than 1 million Americans will suffer from a heart attack this year, and about 150,000 of them will die from it, according to the American Heart Association. Thing is, more than half of the people who have a heart attack don't recognize its symptoms. “People have this idea of the Hollywood heart attack, which is a man squeezing his chest, the feeling of the balloon about to burst,” says clinical cardiologist Malissa Wood, assistant professor of medicine at Harvard Medical School. “So when people don't have that classic symptom that they've seen or heard about, they think, ‘Well, this must be something else.'"
Wood admits that the medical literature describing telltale symptoms can contradict itself, and says the combination of misinformation and downright denial complicates matters. “Basically if you feel something in your back, chest, jaw or tooth that you haven't felt before, get it checked out,” she says. “The way to know is if you experience something you haven't felt before.” For those who've had heart problems previously, the advice often still applies. “The one uniform thing people say is the symptom that they had [the second or third time] was very different from what they had felt previously. And it's not always pain. Sometimes it's just a little discomfort, or an ache.”
For the simplest takeaway, Wood says, think of any symptoms you feel this way: “If you have to google ‘chest pain’ or ‘chest discomfort,’ then probably you first need to call 911.”
Here, five heart attack survivors share their very different experiences — and what they wish they'd realized sooner.
Bill Schaffer, 60, Mantua, New Jersey
Bill Schaffer realizes he should have known better. The stabbing pain in the center of his back whenever he walked up or down stairs. The indigestion. The feeling that two fingers were squeezing the life out of his heart with every beat. He's a retired EMT, after all. He witnessed people who had heart attacks nearly every day. He knew the symptoms, what they looked like, what his patients told him they felt like. But when he started experiencing the same sensations, he told his wife he needed to make an appointment to see the chiropractor.
It was summer 2016. Schaffer had just turned 57. It was hot outside, muggy. And every day the pain in his back intensified whenever he climbed the stairs. Until Saturday, Aug. 27, when his cousins came by. They spent the day together, and then had dinner. “I started feeling a little funny prior to eating,” Schaffer recalls — sweaty without sweating, feverish without a fever. Then, during the meal he felt some indigestion. Still, he wasn't concerned, and retired to the couch for a chat with his cousin. “The pain was starting to build,” he says. No longer did his heart feel like it was being squeezed — now it was being crushed. “It traveled to my shoulder and arms, and radiated to my jaw.
"That's when I put the game together and knew I was having a heart attack.”
Even on blood pressure medication, Schaffer had high blood pressure — not “horrible” like he had seen in some of the people whose lives he saved (or didn't), but higher than normal. Still, neither he nor his doctor were alarmed. Schaffer was religious about his every-six-month checkup with his cardiologist, and taking his meds. “I was doing what I was supposed to be doing.”
But Schaffer's numbers didn't tell the whole story. As director of the EMT department, he was on call all day every day, often under some horrific circumstances. In his town, a western suburb of New York, he'd responded to terror attacks, mass shootings, and the Sandy, Floyd and Irene hurricanes. “I had an extraordinarily stressful job,” Schaffer says. He barely had time to eat, so lunch meant something quick and unhealthy – a hamburger or chicken nuggets. “My eating patterns were horrible."
After Schaffer realized what was happening that summer night, he asked his wife to dial 911. But still he didn't want to appear ill to his colleagues who might respond. “I wanted to go outside to wait for the EMT so they didn't have to come up the stairs, but I was in so much pain I had to lay on the floor.” Schaffer's cousin helped him down the stairs. When the paramedics arrived, they hooked him up to an EKG machine and said, “Hey, Bill, you're having a heart attack. Relax.”
Having since undergone open-heart surgery, Schaffer says he's conscientious about lowering his blood pressure — checking it regularly at home and diligently keeping up with the new medications his doctor has prescribed. “My blood pressure is fantastic now,” he says, adding that he's far below what he once considered safe, and much more comfortable communicating with his doctor when he notices changes or feels anything out of the ordinary.
Susan Madero, 66, Los Angeles
On Valentine's Day, 2015, Susan Madero was sitting in a movie theater watching American Sniper when she started feeling very full, as though she had eaten a big meal — odd, because she hadn't had dinner. Then the indigestion set in, and the sensation of a very large person sitting on her chest. Everything inside of her ribs started to tighten, and she grew short of breath. But Madero knew her husband wanted to see the end of the movie, and talked herself into believing the leftover Chinese food she ate at lunch was just giving her trouble. “It wasn't until I started having pain in my right shoulder and arm, followed with pain in the front of my neck and then up to my jaw, that I thought something was seriously wrong,” she says. But even then she didn't say anything. “Being a woman, I didn't want to make a big deal of this."
After the movie ended she told her husband, “Maybe we should go to the hospital.” Once there, an EKG revealed nothing abnormal. And Madero felt so much better while waiting for further tests, she decided to go home. So, having been there an hour, Madero signed a waiver confirming that she was refusing further medical treatment, and left.
Later that night she was awakened by the same disturbing symptoms she experienced in the movie theater, but decided to “sleep them off.” By daybreak, she could no longer deny that something was terribly wrong. She pulled out her blood pressure cuff; her pressure was 192/98. She and her husband drove to the hospital, although to this day she regrets not having called 911. While her earlier EKG was normal, a second one told a different story. Indeed, Madero had 100 percent blockage in one artery, 98 percent blockage in another and 50 percent in three others.
“I was having a STEMI – a ST-elevation myocardial infarction,” Madero explains. A STEMI, also known as a “widow-maker,” is characterized by 100 percent blockage of the left anterior descending artery, the one that transports a major amount of blood to the heart. If blocked, the heart can run out of oxygen and stop beating. “I will never forget the cardiologist's reaction when he first saw those blocked arteries. He just said, ‘Wow!'"
He also asked if she'd been having any chest pains. In fact, she had been feeling short of breath for several months, but wasn't concerned. “I figured if I could still work out and run on the treadmill, I must be fine,” she says, adding that she believes her every-other-day exercise regiment helped make her strong enough to survive her near fatal heart attack.
Now, she says, her mission is to make more women aware of the signs and symptoms of heart attack and heart disease, and “not to shrug them off."
Robert Neyhard, 70, Wilkes-Barre, Pennsylvania
"Honest to God, I thought it was indigestion,” Robert Neyhard says of “the most horrible pain in my chest” he felt in the middle of an October 2018 night. The local radio talk show host didn't want to stir his wife, so he tiptoed out of their bedroom, drank a glass of 7-Up, and swallowed some antacid pills. “After a big burp I thought, ‘Well, OK, all is fine.'"
The pain subsided a bit over the next couple of days, but would return with a punch, doubling him over. “I couldn't even stand up,” Neyhard recalls, admitting that he felt reassured that he was not having a heart attack because he didn't feel pain down his arms. “I didn't tell anyone, and just hid it and took Motrin and Pepto-Bismol. I was in denial."
Or maybe what Neyhard was feeling was so different from the sledgehammer to the chest he experienced during his first heart attack, at age 49, that he couldn't see the link. That time, right away he knew what was wrong — after all, his father had died of a heart attack at 63; his mother at 36. That time, Neyhard rushed to the home of a neighbor, a doctor, just a few houses away. “It was the perfect storm,” he says today of all his cardiac risk factors. “I had bad genes, was exposed to Agent Orange in Nam, and didn't take care of myself."
The pain that jarred him from sleep some two decades later “was a different kind of pain,” he says. “It lingered."
His wife urged him to see the doctor, but Neyhard kept insisting it was just bad indigestion. After all, he had a checkup every six months, felt more like 40 than 70, and was vigilant about taking his medications. “I had no pains, no aches. I had blood work every six months. If I was in denial, it was because I felt OK,” he says.
But his wife knew otherwise, “Not for three days!” she shot back when her husband kept insisting he had heartburn — and went ahead and made an appointment for him on her own. When Neyhard walked in the office, he says, his physician “looked at me and said, ‘I need you to go to the hospital right now.'"
After just 10 minutes in the emergency room, doctors were catheterizing him, explaining that he was mid-heart attack, and had been for nearly a week. That was on a Friday. Five days later, he was still in ICU, waiting to be fitted with a cardiac vest to stabilize his heart. That's when he went code blue. “I only realized what happened after they hit me with the paddles a couple of times. It was very dark, and I could hear someone screaming in the distance,” he recalls about the two minutes he spent without a beating heart. “Eventually I realized that someone was me.”
Neyhard spent eight days in the hospital before being discharged with a defibrillator implant — to help in case of future heart outages.
Cathie Lazarus, 58, Manhattan Beach, California
TV producer Cathie Lazarus was two months into her training to be a volunteer for the Los Angeles Police Department Reserves when she appeared to have dropped dead on the gym floor. “I was doing interval training with a new personal trainer; I had just finished throwing a weighted ball back and forth while also doing situps,” she recalls. But that's about all the divorced mother of two grown daughters remembers about the event that nearly took her life at age 52. “I'm told that I stood up after finishing and said, ‘Whoa!’ and dropped. My heart and breathing stopped instantly. Can you imagine being my trainer and thinking you had just killed your client? I didn't regain consciousness for a couple of days."
Lazarus suffered a sudden cardiac arrest (SCA) — different from a heart attack in that it's an electrical issue rather than a mechanical one, and a phenomenon that kills more often than it spares. Basically it's like a fuse blew out, but that fuse was her heart. “Cardiac arrest causes sudden death,” she says. “So I felt nothing.” Indeed, about 90 percent of SCAs prove fatal, according to the AHA. Only some 25 percent of those who survive can point to any symptoms that preceded their SCA.
Bystanders at the gym and, eventually, paramedics, spent nearly 30 minutes doing CPR, trying to bring Lazarus back. And the EMTs continued performing CPR until her heart finally started beating on its own at the hospital.
Lazarus was 18 when she learned she had a heart murmur. But she says she was never instructed to follow up. After her SCA, she was diagnosed with a heart condition called hypertrophic cardiomyopathy (HCM). “If you ever hear of young athletes dropping dead on the field, they typically have this disease,” she says, explaining that now she has an implanted cardiac device that acts as a defibrillator in case of another SCA.
"I was super-lucky,” she says, noting that only some 5 to 10 percent of those who survive a SCA don't have cognitive deficits as a result. “It takes my breath away when I think about that."
Angelo Keyes, 54, Dallas
Bodybuilder. Gym rat. Retired semipro football player. Angelo Keyes is all of those things. So in 2014 when the entrepreneur was at the gym lifting weights to strengthen his shoulders and chest, he didn't think much of the strain he felt in those areas. “You get so used to those aches and pains and nicks and dings,” he says. “I thought I had pulled a muscle in my chest and shoulder."
But the pain persisted. A trained CPR instructor, Keyes phoned his wife. “I told her, ‘If I didn't know any better, I would think I was having a heart attack.'” She told him to head straight for the hospital a mile down the road, but he told her he was coming home to lie down. But first he needed to run a brief errand. “That took about five minutes, and by the time I was done I could barely stand up. I realized I really was having a heart attack.” He called his wife and asked her to take him to the hospital.
Keyes’ vitals there were fine. But a catherization revealed significant blockages in three of his arteries. “The doctor came in and told me I needed emergency surgery,” he says.
Waking up in the ICU after a triple bypass, Keyes says, “I was in the most pain I had ever felt. I felt like I was suffocating and couldn't breathe.” Yet because he had that procedure, when he had another heart attack a year later Keyes again missed the signs. “I was at the gym again, lifting weights,” he says. “I came home and just wasn't feeling good, but figured, I had the bypass, everything should be fine.” It wasn't. “The doctors got on me for waiting too long to come in,” he says. “But the pain really wasn't as bad as the first one."
Nor was the pain that marked his third heart attack, in 2017, when again he was working out at the gym. “I started feeling funny and this time I didn't wait.” Keyes rushed himself to the hospital, where they inserted a stent. But three heart attacks in three years was too much for the attending cardiologist to let pass. So he ordered an advanced lipid test, which revealed a genetic disposition to producing bad cholesterol and clotting. “Finally, I had an explanation for why this was happening,” says Keyes, who has virtually abandoned meat in exchange for a mostly plant-based diet. “I have steak maybe once a week,” he says. “That's my treat."