The last few weeks, you may have noticed a delay in publishing my posts. In fact, it’s been a few weeks since I’ve posted any new content (don’t worry – those missing posts will get uploaded shortly!). What started as simple indigestion (or so I thought) quickly spiraled out of control; I landed in the hospital in critical care with doctors working against the clock to save me. This seemingly minor symptom was actually an indication of a serious heart condition.
How did something so insignificant have such a consequence?
A quick background
At the end of July, my wife had a surgery to repair some damage to her back. She was going to need a few weeks to heal and recuperate; ultimately, she required more time due to some complications. During recovery, she wasn’t allowed to bend her back or pick up anything. As a result, I started handling all of the chores. The extra activities meant a bit more exercise for me. In hindsight, this additional work likely helped to surface my issues. Her surgery and recovery very likely saved my life.
I generally try to eat healthy and exercise regularly. There’s a number of health conditions in my family tree, so I decided in my 20s to try to make changes to my lifestyle. I minimized sugars and sodium, started eating lots of fish and vegetables, and swapped butter for extra-virgin olive oil. Unfortunately, none of this changed my genetics. 🤷
The joy of food
The problems started very simply. After a night of incredible (🔥 spicy) Indian food, I felt a strong heartburn. In fact, eating almost anything (including toast) seemed to give me indigestion. After several days of this, I set up an appointment with a gastroenterologist to figure out what was happening. She scheduled a colonoscopy and endoscopy to identify the cause. The earliest opportunity would be almost one month away. In the mean time, I received a new diet and some medicine to minimize indigestion.
I would later learn that either of those procedures would have been fatal. I also learned that many serious heart conditions are completely indistinguishable from heartburn. In fact, I was told that most people who experienced a heart attack indicate that first though it was heartburn!
A subtle warning
I started to notice that my heartburn had a pattern. It seemed that any activity that “bounced” my stomach (such as quickly moving up and down stairs) frequently led to the burning sensation. Once it started, sitting and raising my arms could help reduce the severity. Shortly after that, a new symptom emerged: when the pain reached peak intensity, I would break out in a cold sweat. None of these symptoms are typically consistent with heartburn, so I decided to reach out to my heart doctor.
I later discovered that cold sweats are a significant red flag. I never felt any shortness of breath, back pain, arm pain, or jaw pain; these typical symptoms of a heart condition were not present.
Two years earlier, I had run a full suite of heart tests – including a stress test and echocardiogram – to test my heart’s health. Both came back showing excellent results. I had no calcium buildup, so plaque was unlikely; plaque nearly always contains calcium deposits. The ECG showed that all of my heart structures were operating properly. I completed the treadmill stress test without incident, showing excellent heart and lung capacity. I was in excellent health.
Was there a chance that one of these could be wrong or something might have changed? It seemed unlikely, but my cardiologist shared the same concern. I was asked to come in immediately (same day!) for an evaluation. To rule out any new heart issues, they recommended a nuclear stress test (NST) and a new echocardiogram. For those not familiar, an NST uses a radioisotope to enable doctors to see the blood flow through the heart. After viewing the resting flow, an additional drug is administered to dilate the blood vessels (essentially, simulating exercise). This allows them to see the blood flow when the heart is more active. They asked me to return the following week for the first available appointment; their insistence on immediate action saved my life.
In the mean time, they gave me some medicines to take as a safety precaution. One of these was nitroglycerin; I was asked to take it the next time I felt the indigestion. Within moments of taking a tablet, the “indigestion” disappeared. Unfortunately, that confirmed that my “indigestion” was actually angina, a pain indicating a lack of oxygen (blood flow) to the heart.
Failing a test or two
The NST did not go as planned on that fateful Friday. Shortly after they started the dilation medication, I felt a growing pain in my chest. Before I knew it, the intensity of the pain was overwhelming. I could feel it in my left arm and my back. After another minute, the pain spread to my jaw and then to my teeth. Thankfully, the dilation medication is easily counteracted. After a quick injection into my IV, the pain disappeared.
I was advised that the doctor wanted to review the results with me today and not wait for the scheduled follow-up. The look on the technician’s face told me something was wrong, but the doctor’s face was even more telling. She believed that a blockage had developed. This was highly unusual given the earlier test results, so I needed to go to the hospital for a heart catheterization. Essentially, they would need to thread a camera through an artery in my right arm and directly examine the inside of the artery. If a blockage was found, they could use a balloon to remove it and a stent to keep it open. The full procedure would last about an hour.
She recommended strongly that I go immediately, despite the test being scheduled for Monday. She wanted to minimize my risk and ensure I was seen as early as possible on Monday. Her concern was that the blockage appeared to be in the left anterior descending (LAD) artery, putting me at risk for a sudden “widow-maker” heart attack. This situation causes your heart to suddenly lose 40% of its blood supply. It has a 12% survival rate outside of a hospital, and only 25% of patients in a hospital typically survive. I hated the idea of being confined to bed for a few days, but decided to take her advice and check into the hospital.
This was the right call. I would not have made it to Monday. Within 24 hours, my condition started to rapidly deteriorate despite the constant monitoring and medication.
One-in-a-million odds
While I was in the hospital, I was put on blood thinners and given medicines to relax my heart. My blood was examined every few hours (ouch!) to monitor by progress, balance my electrolytes, and ensure that the blood thinner was properly calibrated. Despite these treatments (and being confined to bed), I had four severe angina attacks within a few hours. I learned this is the hallmark of unstable angina; it occurs while you are at rest instead of being a response to activity. It can indicate that the plaque in the artery has ruptured, triggering a series of reactions that can close the artery. More powerful medicines were administered, and my blood was tested even more frequently.
On Monday, they performed the catheterization. Almost immediately, the doctor informed me I was “within minutes or at most a few days” of a fatal incident. I was on borrowed time; even walking could be fatal. He then opened an artery in my leg and installed a balloon designed to help my heart pump blood more efficiently. Afterwards, I was put in an ambulance and transferred me to Emory St. Joseph’s hospital. I was informed that I would be a top priority for surgery, and was scheduled for early the following morning.
Three of my arteries had blockages of nearly 99%. Any one of those completely closing would stop the blood flow to a significant portion of my heart, triggering a potentially lethal “silent” heart attack.
My doctor later told me it was a “one in a million discovery”. The condition often has few (if any) symptoms, making it very rare to discover it in time. As a result, it’s nearly always fatal. Because I had no calcium deposits, multiple plaques were able to invisibly grow. Eventually, they ruptured through the walls of the arteries. My body tried to clot the damaged walls, which inadvertently started closing the arteries. For most people, the first sign of trouble is a sudden, massive heart attack. In fact, similar issues have caused the sudden collapse and death of numerous famous athletes. For example, Olympic medalist Dale Oen, runner and author Jim Fixx, baseball star Darryl Kile, and Olympic skater Sergei Grinkov all died suddenly from multiple arteries having smaller blockages than mine! I was unbelievably lucky. 🍀
The surgery
At the hospital, I was prepped for an open-heart surgery. They needed to perform a coronary artery bypass graft (CABG, pronounced “cabbage”) on Tuesday morning. Because of the severity of my case, I was moved to first on the day’s roster. During the procedure, they harvested a vein from the left leg, my left radial artery (forearm), and the mammary artery. These were used to create the bypasses necessary to restore blood flow to my heart. The entire process took about 6 hours. While they worked, I was placed on a heart lung bypass machine and my heart was stopped.
Waking up from the surgery, I immediately realized that I had survived. Statistically, I was now past the riskiest part of the procedure. The surgeon and cardiologist both let me know that my heart seemed to be in excellent shape – no damage or signs of any past heart attacks. As a result, I could expect a complete recovery. They didn’t expect I would have any further complications.
Over the next few days, they had me walking to build up my strength. On Saturday, I was sent home. I had no idea the hospital recovery process was so short! For the next week, I mostly slept and tried to regain my energy; I would wake up long enough to eat and exercise. Since then, I’ve improved dramatically. I’m already walking nearly two miles in 30 minutes.
Lessons learned
The next few weeks will be spent recovering and regaining my strength. Each day, I am able to walk further and longer. I can speak for longer periods of time. The complete recovery will still take 3-6 months, but I continue to be surprised by how fast I’m healing.
Thankfully, I was lucky enough to catch a few symptoms of a serious heart issue, including cold sweats and heartburn that appeared after moving. I didn’t have the typical signs of a heart attack or heart problem, making it very easy to miss. I didn’t feel a crushing chest pain, pain in the arm/jaw, or shortness of breath. I was lucky enough to recognize that my symptoms were not characteristic of heartburn (and to have doctors that reacted quickly).
In short – if something doesn’t seem to quite make sense, make sure to check with your doctor. In addition, if you have a heartburn that doesn’t go away, make sure to have your cardiologist check it out. It might be nothing – or it just might save your life.