This article is a transcribed edited summary of a video Bob and Brad recorded in May of 2022. For the original video go to https://www.youtube.com/watch?v=DmKv9JZI_Pk&t=9s
Brad: Today we're going to discuss heart attacks, early signs, and symptoms. We're going to discuss some treatments as well as some variations between male and female symptoms. So, stay tuned, and Chris is going to give you everything you're going to need to know.
Chris: All right, so heart attacks, in the United States, and pretty much worldwide, are the number one killer for both males and females.
Brad: Wow.
Chris: When we have a heart attack, it's not like what we see in the movies where it's like, "Oh my God, I'm having a heart attack, get help." It's not like that. Sometimes they are, 90% of people are going to present with massive crushing chest pain and shortness of breath. Those are the top two symptoms of a heart attack. But there are subtle differences, there are differences between men and women, to a degree, and we'll kind of dive into that a little bit as well. But the symptoms of a heart attack oftentimes ramp up gently, or quietly, before we actually have the actual heart attack.
Brad: So you mean over a period of a day or weeks?
Chris: Days, weeks, even up to three to four weeks, particularly in women, so we'll touch on that a little bit. But men can have that too, so it's not exactly the same. What can happen is we have little tiny vessels, and basically, the definition of a heart attack is basically there's an occlusion, blood flow is stopped, it doesn't feed the heart muscle and it causes damage. So time is muscle in the world of a cardiologist.
Brad: So something gets in the vessel, blocks it like a dam, and there you go, you have no blood.
Chris: Exactly, so it's basically a plaque or just a little bit of fat, or junk, goo that's kind of hiding around in the arteries. It plugs it up, and it doesn't give oxygen and rich nutrients to the heart muscle itself. The longer that it's occluded, the more damage is done to the heart, and obviously, the endpoint can be death. So, time is of the essence to recognize these symptoms, and sometimes it's a little bit more simple, and sometimes it's a little bit more complex.
Brad: Sure.
Chris: Overwhelmingly, males and females present with overwhelming chest pain, it almost feels like an elephant is sitting on your chest and squeezing. You have difficulty breathing. And this is where it kind of starts to break down between men and women. Women may have things that led up to this. So for the last month they just kind of feel fatigued when they're just doing normal household tasks that they do day to day, all of a sudden they're just, "Man, I gotta take a nap, I am just wiped out." Things that just shouldn't crash you, from that standpoint. They may think, "Well, I've been busy at work, I've been chasing the kids around all day." Just lots of running and gunning. Maybe it's just a little stress, little anxiety, and so they kind of bypass that fatigue. They might have a little bit of chest pain, but then it all of a sudden, it seems like, well maybe it was some indigestion. So they delay time to care. And so the problem is if you feel something you want to say something. How do we delineate between, is it a little bit of heartburn? I don't want to run to the doctor every five minutes and think I'm having a heart attack, but at the same time, you don't want to ignore very serious symptoms. That's one of the things that's very crucial.
Brad: I want to go back, you said women may experience that more often, but men don't?
Chris: Not as often, usually for men, it just seems like it's the chest pain. Which, a guy might think it's a pulled muscle in their chest in a lot of cases, like they're working out, or they did some yard work. And then all of a sudden they're like, "Yeah, I just don't feel right. "I just can't catch my breath," and all of a sudden they may be sweaty, and kind of clammy.
Brad: Women don't?
Chris: Oh yeah, no, they do, too. Men and women have the same experiences, but women, when they present with a heart attack in a lot of cases describe more symptoms, and in more detail than men. Men, it's pretty simple, for whatever reason. And I don't know if it's because it was often thought of as a male dominant disease, which is 100% wrong. Males and females, it's number one for both of us on the death list.
Brad: Okay.
Chris: Over time it's become recognized better, but the interesting thing is we're talking about the ramping up so you can get some of that fatigue, shortness of breath, sometimes pain that radiates down the arm up into the neck and jaw. Which seem like traditional things, but sometimes people just blow it off as "Oh, I pulled a muscle in my neck." So one thing that people can do if you think you did have a pulled muscle is if you do a little stretch, it's going to go away. So if it doesn't go away, it is consistently there or gets worse, that is definitely the time to probably be looking at 911.
Brad: And oftentimes that feeling will come with increased activity.
Chris: Yeah, and that's the other thing I was going to touch on. So if your chest has been hurting you and you're sitting down, you're like, "I'm just going to get a glass of water and see if something helps." And if you get up, and upon exertion, that chest pain is getting worse. That's also another critical sign that probably something more dangerous is going with the heart itself. So it doesn't matter if it's more neck pain, more back pain, more pain down your arm, or even in the right arm which is interesting, because usually, we think our heart's on the left side of the body so if we have right sided pain, that's kind of strange. Or even the right side of your back. So women will present, and be more descriptive, of all those subtler symptoms, which are not the big two, which are chest pain and shortness of breath. So that's where it differs a little bit. Some of that may be due to women having a slightly smaller heart, a little bit faster heart rate, and also smaller blood vessels. And those smaller blood vessels may be what leads to more of the subtler symptoms like the pain down the arm, the neck, or in the back, or even nausea or indigestion kind of symptoms.
Brad: Sure.
Chris: So for whatever reason, though guys can equally have those in a lot of cases. But it just seems like it's more present and more descriptive with women. Women will present and tell you at least three different symptoms or more, whereas men will just tell you two. You've got the most skilled nurses and doctors helping you right away to try and get through all this, and they go through a litany of things when people are having a heart attack. They have very specific protocols for that.
Brad: Correct.
Chris: Circulation is everything. And so we want to make sure the sooner that they can get that clog fixed, the sooner you're going to recover and get back to healthy.
Brad: So if someone's having these symptoms and they're thinking "Maybe I should go in." What are you going to do, jump in the car and drive? Call 911? Or?
Chris: We would recommend calling 911 if it's possible. If you live in a little farm community, and the closest hospital is an hour away, it's kind of a crapshoot. Most doctors and legal experts are going to tell you to call the ambulance because the ambulance can provide the care that you need along the route. If you're having a heart attack, and there's no saying when it's really going to turn bad, like if all of a sudden you have asystole or something, where your heart stops beating. If you're in a car, now you've crashed the car or crashed into another set of people. So, if you can avoid driving yourself to the hospital at all costs. That is most ideal. Number one would be 911, the paramedics on those crews, that's their bread and butter. They know all about how to treat you, get things going, and stabilize you as much as they can so that when you get to the hospital the doctors can go to work right away.
Brad: Right and they're communicating, so the doctors know what’s going on.
Chris: They're communicating as they go, yes. So yeah, it's very involved, and it's quite intricate, but incredible teamwork. So, for the survival chain, it's pretty impressive.
Brad: Now, I didn't know if you wanted to mention this, but you talked about you can self-treat a little bit by taking an aspirin?
Chris: Yeah, so if appropriate. I think it would be okay to chew an aspirin, so you don't want the enteric-coated aspirin at this point, you want the plain old white tablets. If you're not on a blood thinner, and you don't have an aspirin allergy, we would recommend chewing one aspirin, just one 325 mg aspirin. Basically, it takes five minutes to get into the system and start helping to improve blood flow. So that five minutes can make a difference in your life or a loved one's life.
Brad: So, you're saying if you feel the pain, and you're concerned it is a heart attack, you call 911. And then?
Chris: Oftentimes the operators are very skilled to listen for things. They may actually go ahead and tell you to chew an aspirin. So that's one thing. And if all you've got in the house is enteric-coated aspirin, still chew it.
Brad: What's this, enteric coating?
Chris: Enteric-coated. So, a lot of times, they're orange in color. The coating is designed to protect your stomach from stomach ulceration so it dissolves in your intestines and then it absorbs.
Brad: So you can't chew those?
Chris: You can, it's just harder to chew. And it can be kind of hard on the teeth. But at the end of the day, I think that's the most important thing. When it comes down to it, what do we do? We want to recognize the symptoms if it's not getting better. The other thing with women to men, it seems like they take 37 minutes longer to report a heart attack than men for some strange reason. Oftentimes it may be that psychology just says, "Well, it's not happening to me, I'm too busy for this,” or, "I've got so many other things going on. I gotta take care of the kids," or “I gotta get the grandkids. I have to pick them up at school." And they're just thinking about all sorts of other things.
Brad: Or do they have a higher pain tolerance?
Chris: Much higher pain tolerance, too, I think. I think there are not a lot of clear studies that suggest that, but you'll hear, anecdotally, that doctors will say "I just think women are just tougher." And so they just attribute it to, "I'll sleep it off," or "I'll walk it off," so to speak, or "Rub some dirt on it, and it's just going to go away."
Brad: Well, I think most physical therapists deal with a lot of pain with treatment, particularly total knees. That's one thing you do try to get pain with, and hands down, I'm working with a woman I can push her harder than I can any man with a total knee.
Chris: I think they are, I don't think there's anything about it, I think anybody will tell you that women are tougher than men. I don't care what you say. They have kids, we don't. So I mean it's a pretty simple argument from that standpoint. But all kidding aside, when we're talking about this, if it just doesn't seem like it's getting better if it seems like the pain is getting worse upon just taking a simple walk across the room, it's 911 time. It's something that I can't stress enough. Some people say, "Well I don't want to go, because I don't want to waste their time." "I don't want to be embarrassed if it's just like a stupid case of anxiety." You know those are all wrong. I mean, let the pros search it out. They're highly trained, they are expert medical personnel. They will do what they can to sort out what may not be real, versus what is devastatingly real.
Brad: Sure.
Chris: That's the one thing that we want to stress more than anything else.
Brad: Both Chris and I have been to the ER with heart attack symptoms. They weren't heart attacks, but we were both glad we went because you feel so much better. Then you try and figure out what the problem was. And we both did
Chris: Absolutely. At the end of the day, it's like "Whoo, at least it's not that." You can always deal with a muscle pull or anxiety. That's not simple, and that's not to belittle anxiety. The symptoms feel the same, and so that's the thing that's hard. We just can't, as human beings that are not trained in the medical profession really recognize, "Well, is it just indigestion?” "Is it just a pulled muscle in my shoulder, neck, arm, or jaw?" It’s just too hard to tell. Let the pros know, they're going to help you. I think that's the most important takeaway.
Brad: All right, so, there you go. Heart attacks, symptoms, signs, don't mess around with it. I thought aspirin, was something I didn't know about, but I think a lot of medical professionals are aware of it.
Chris: Absolutely. Oh, it is. Aspirin is important because it helps, flow is everything when it comes to circulations. It thins the blood just a little bit. Just five minutes of getting that in your system versus swallowing, which takes about 12 minutes, so that's why you want to chew it.
Brad: Do you wash it down with water?
Chris: Well you want to chew it, just chew it and swallow because actually, you really don't want to drink a lot of water because you could regurgitate. So if you can just chew it and swallow it that's best. And I guess really we'd be remiss if we didn't talk about prevention. There are risk factors across the board, whether it's, age, genetics, smoking, not smoking, drinking, or not drinking. So any of the things. Eating well, and getting exercise, are two of the biggest things that you can do. I mean, sometimes you can't outrun genetics but you can certainly do things to change the table.
Brad: Right, I think everyone knows smoking is a big no-no.
Chris: It's a big no-no, but it's just something that you're on the fence on, if you have the ability to try and quit smoking, please do. Just make sure you get out there and walk, try and stay active, and do active things. Even though it doesn't seem like maybe it's an exercise program, taking a walk every day is a perfect thing to do to help protect that heart.
Brad: Right. All right, very good. Enjoy the day and stay healthy.
Chris: Thanks, guys.
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