Rob Steinberg never thought he would have a heart attack.
Or, at least, not at 45 years old – and certainly not when he was in the best shape of his life.
Rob had completed his 3rd Ironman triathlon, finishing near the top of his age group, and was training for his 4th. Focused on trimming critical minutes off of his time, he noticed his throat felt very dry during strenuous parts of his training. He ignored it for a few weeks, but the sensation wasn’t going away; in fact, it was getting worse. Rob started feeling the throat dryness earlier in his bike rides and even started to feel it when he wasn’t training. He mentioned his symptoms to his wife, who insisted that he see a doctor.
Rob decided to go to an urgent care, where the provider recommended an electrocardiogram (ECG) ECG. He refused, thinking there was no way this was heart related.
But the dry throat symptoms kept bothering him.
A few weeks later, he went to urgent care again. This time, he agreed to the ECG. Not only was the ECG abnormal, the provider wanted to call an ambulance!
Rob drove himself to the emergency room, where he was indeed having a heart attack. He had an urgent heart catheterization, which found not one, but two blocked heart arteries. He had stents put in to open the arteries, and fortunately only had mild damage to his heart.
Rob had never considered the possibility that he could have a heart problem. Sure, he had a family history of heart disease, and his cholesterol wasn’t great, but people with heart problems had chest pain – and they weren’t Ironmen!
We Are All at Risk
So, if someone like Rob could fall prey to heart disease, where does that leave the rest of us? At risk. Probably, at least. Adult men in the United States have about a 60% chance of having a heart attack, stroke, or heart failure in their lifetime. For women, it’s not much better, with 56% destined to suffer from heart disease or stroke.
Considering those statistics, almost all of us can count on being affected, either personally or through family members or loved ones. Cardiovascular disease is the leading cause of death in the US. Each year there are:
- 800,000 deaths (2,200 die each day, about 1 every 40 seconds)
- 735,000 heart attacks
- 800,000 strokes
- 800,000 people newly diagnosed with heart failure
So, if the question is, “Who should be concerned?”, the answer is, “All of us.”
Recognize the Symptoms
Believe it or not, Rob was fortunate. Fortunate that he survived. For about 25% of people, their first sign of heart disease is they die. Doctors call this “Sudden Death”, but typically, there are symptoms before death that, much like in Rob’s case, are ignored.
So, what are the symptoms of heart disease? Everyone knows about chest pain or pressure that radiates to the left arm, but these “typical” symptoms are NOT the most common. There is a lot of individual variation in how heart disease presents, making it a challenge for all of us, including doctors, to determine when symptoms are heart related.
The advice I give my patients about possible heart symptoms is this.
1. Symptoms that occur with physical activity or emotional stress and go away with rest need to be evaluated by a medical professional.
2. Symptoms like chest pain or pressure, nausea, indigestion or heart burn that aren’t going away – particularly if associated with shortness of breath, sweating, palpitations or feeling like you will pass out need to be evaluated by a medical professional urgently. Don’t drive yourself to the hospital, but call 911.
3. If you’re concerned, I’m concerned. Be safe and have your symptoms evaluated by a medical professional.
Rob’s story was a success because it ended well. He has resumed participating in Ironman competitions, although he doesn’t push himself to the limits anymore. More importantly, he has resumed his duties as a loving father and husband. He and his wife have even started a foundation whose mission is to build a family community for heart attack survivors, and their families.
R. Todd Hurst, MD, FACC, FASE is a board-certified cardiologist, Center Director for Cardiovascular Health and Associate Professor of Medicine at the University of Arizona/Banner University Medical Center-Phoenix. Hurst spent 12 years at Mayo Clinic Arizona as an Associate Professor of Medicine in the Mayo Clinic School of Medicine, Founding Director of the Heart Health and Performance Program, and the Carla J. and Russell P. Paonessa Chair, Wellness and Health Education. He has over 50 publications in peer-reviewed journals and regularly speaks nationally and internationally at medical meetings, primarily on the prevention of heart disease. You can read more from Dr. Hurst on his website.