Just one month earlier I'd passed a physical with flying colors. My blood pressure was its usual 110/70. My bad and good cholesterol levels were respectively low and high. I never smoked. I never had diabetes. I exercised pretty regularly. I'd been avoiding "bad fat" and salt for many years and ate a fairly healthful diet. I wasn't overweight. My parents, who are now in their 80s, never had high blood pressure or heart disease. So how did it happen?
Most likely, stress.
Get developments in medicine, nutrition and fitness delivered to your inbox with our The Health Report newsletter. Sign up »
Stress, the silent killer, has a way of sneaking up on you. Its effects can be deadly.
Three days before the attack, I'd taken a public stand against a local rezoning initiative. It was a hot issue, and when the attack struck, I was at a party discussing it.
Two weeks before the attack, my husband and I had made the difficult decision to put down our beloved 15-year-old dog. Then we adopted another pet we learned later was aptly named the Tasmanian Devil by a previous owner.
Three weeks before the attack, the stock market plunged. I was terrified that our savings were kaput.
Then there was a series of demanding issues on both sides of our families. My husband and I became enmeshed in helping certain family members. On top of managing our own lives, it was simply overwhelming.
Don't get the wrong idea. A few months, even a few years of stress didn't give me a heart attack. I gave it to myself. The damaging effects of stress on my coronary arteries — a buildup of plaque — were cumulative. Throughout the years I'd allowed life's challenges to get under my skin, when I would have been better off letting them roll off my back.
Plenty of people deal with issues like mine, and much worse, without having heart attacks. I hope you are and will remain one of them. But my real message is this: No matter how healthy you are, don't get complacent. Heart attacks happen, even to the "healthiest" of people.
And don't ignore the signs, as I did at the party.
I had just moved on from the rezoning conversation when I felt a tightening, gripping sensation that spread from the bottom of my ears, down my neck and around my entire torso, and from my shoulders to my fingertips. I could barely breathe. I thought I was having a panic attack.
I stumbled over to the hostess, whispered that I didn't feel well and asked where I could rest. She indicated her bedroom. My inner voice was saying, "You know, this could be a heart attack." I ignored it at first, but eventually I asked for aspirin, just in case.
The hostess sent my husband in to check on me. I was feeling better but took two aspirin anyway and went back to the party. I couldn't imagine making a scene by having an ambulance come for me in front of all those people. So I played down my symptoms and pretended everything was fine.
Later that night we watched a movie at home, and I didn't have any more symptoms. But the next morning the gripping sensation and shortness of breath returned. I finally called 911. An ambulance whisked me to the hospital.
My X-ray, CT scan and electrocardiogram readings were all "normal." The cardiologist said my symptoms could be gastrointestinal. But he took the precaution of keeping me at the hospital and testing my blood through the night, which was a good thing. My cardiac enzymes (CPK, LDH, SGOT) spiked, suggesting I'd had a heart attack. An angiogram confirmed it.
The test results explained the weird pressure I'd felt in my abdomen the morning of the party and why I felt a little bit as if I were coming down with the flu the evening before. Two more signs that I'd ignored. I thought the pressure was from gas or constipation, and I had no idea at that time that many women have flulike symptoms days or even weeks before they have a heart attack.
I was very lucky. I had only one partially blocked artery. The cardiologist said my heart was very strong and did not sustain damage. The artery was too narrow to stretch, so he did not perform angioplasty. I'm being treated with daily doses of two types of blood pressure medication, a blood thinner, a cholesterol production blocker and baby aspirin. But I must confess, I still have a long way to go on improving how I manage stress.
I was also lucky that I had a second warning. I was foolish not to call an ambulance at the party. My self-consciousness could have cost me my life.
Don't rely on luck to save your life. Learn the many symptoms of heart attacks, and realize that they can differ from person to person. If your body gives you even the slightest indication that you're having an attack, call 911, no matter where you are or whom you're with. It really is a matter of life and death.
Markowitz is a writer and editor who lives near Phoenix.