Symptoms of heart attack nothing to mess around with

Even if someone is uncertain of the cause, calling 911 while experiencing symptoms of a heart attack could mean the difference between life or death.

After a morning of cross country skiing with friends near Blue Mounds earlier this year, 70-year-old Joe Mirenna thought his nagging arm pain, fatigue and shortness of breath were just inconvenient reminders that he was out of shape. After all, it had been close to a year since he’d been on his skis.

But, as his arm pain worsened and his anxiety grew, Mirenna sensed something wasn’t right and knew he had a choice to make: drive the 20 minutes to his home in rural Belleville, and hope his symptoms improved, or swallow his pride and call 911. The decision he made likely saved his life.

“The first thing I did when EMS arrived was apologize, because I was sure that I was just overreacting,” said Mirenna. “But I realized my instincts to call them were correct, when the EMT told me that I was, in fact, having a heart attack. That’s when things got serious.”

Mirenna didn’t know just how serious things were until he woke up in a bed at University Hospital, still wearing his ski pants and ski boots from earlier that day. Doctors told him his left anterior descending artery had been 100 percent blocked when he arrived – a type of heart attack so dire, it is commonly referred to as the “widowmaker.”

“Cardiologists often say that time is muscle, when it comes to treating heart attacks,” said Dr. Gregory Tester, interventional cardiologist at UW-Health and the doctor who treated Mirenna. “That means the sooner we can restore blood flow to the heart, the greater the chances that person will not only survive, but hopefully avoid any long-term consequences that occur when the heart is deprived of blood for too long.”

Luckily, time was on Mirenna’s side, thanks, in part, to the paramedics who initiated the field-activated heart attack protocol, which set off a cascade of critical preparations at University Hospital. By the time Mirenna arrived in Madison, doctors had already seen his electrocardiogram results, and were prepped and waiting for him.

Mirenna bypassed the emergency room and was delivered straight to the cath lab, where Tester and his staff opened his blocked artery, and restored blood flow to his heart. The whole event, from the moment he called 911 in Blue Mounds to the moment doctors went to work on Mirenna, took less than 60 minutes – or what doctors often refer to as the golden hour, because heart muscle starts to die within 80-90 minutes after it stops getting blood.

“He suffered very little long-term heart damage, his heart pumping function has remained relatively normal, and that’s all due to him getting here and his artery opened up as quickly as possible,” said Tester.

Tester urges anyone who experiences heart attack symptoms to seek immediate medical evaluation, by calling 911 or going to a nearby emergency department.

Early signs of a heart attack include sudden chest discomfort; shortness of breath; discomfort in the arms, back, neck, jaw or stomach; cold sweats; nausea; and lightheadedness.

While women experience the same symptoms, they are more likely than men to feel the lesser-common symptoms of nausea (accompanied by vomiting), back and jaw pain, and shortness of breath, without chest pain.

Tester acknowledges that it might be hard for some people to make the leap from experiencing symptoms to calling 911, but as Mirenna’s case shows, it’s much better to be safe than sorry.

Mirenna said that if he’d made the decision to drive home instead of call 911 that day, there’s a good chance he wouldn’t be here to tell his story. Instead, he is already back to hiking with his wife, snowshoeing and cross country skiing with his friends.

“I’m one of the lucky ones,” said Mirenna. “It’s a miracle that I’m here at all, but probably even more so that they were able to fix this serious problem in super-fast time. I had amazing care all around and I feel great.”