In spring 2018, Tim Walker was working on a PhD in microbiology. Over the course of a week, he started feeling a little breathless during his morning commutes to University College London and had what felt like muscle aches around his upper back and shoulders. He put the symptoms down to a nasty virus. I was 31, he says. Why on earth would I suspect that I was having a heart attack?
As the days passed, his symptoms grew more pronounced. Eventually, he woke on a Saturday morning to the most intense pain Ive ever experienced an otherworldly, constant stabbing pressure in the collarbone area, neck and jaw, on both sides. He started coughing and vomiting, but there were no chest pains. Im not a religious man, but I remember praying at one point. After no more than 10 minutes, the symptoms went away, just as suddenly as they had appeared. He assumed it was a really nasty bug. Later, he became feverish and decided to take a few days off uni to get my strength back.
It wasnt until he was sitting at his desk the following Thursday, more than a week after symptoms had begun, that he sought medical attention. My left arm suddenly went cold and numb. He walked to the nearest A&E, where he was examined by a flurry of bemused doctors. Before the day was out, he had been diagnosed with a heart attack and undergone emergency surgery. An artery had been blocked and needed two stents to re-open it.
While Walkers age was an additional red herring (the British Heart Foundation estimates that the chance of a 31-year-old having a heart attack is 0.02%), the slow onset of these easily misinterpreted symptoms is surprisingly common yet little known. A recent US study published in the European Journal of Cardiovascular Nursing found that, while 57% of patients reported an abrupt symptom onset, the other 43% experienced gradual symptom onset.
Both are a medical emergency and require urgent help, said the studys author, Sahereh Mirzaei, from the University of Illinois. However, those with a gradual onset of symptoms experienced, on average, eight-hour delays in getting life-saving treatment.
The study highlights the need for greater public education, says Prof Sir Nilesh Samani, the medical director of the British Heart Foundation. But even people in the medical profession can be misled. I know doctors who have put their own heart attacks down to indigestion and gone to bed for a while. Sometimes if youre having a heart attack you feel you want to be sick they think its all to do with what they might have eaten. These are features that sometimes delay diagnosis.
Walkers case is unusual not only because of his age, says Samani, who is also a consultant cardiologist at Glenfield hospital in Leicester, but because of the duration of his symptoms, even for a slow-onset attack. Usually, it doesnt go on for a few days, but several hours, as opposed to a big bang heart attack when within a few moments you know something has changed.
Sudden heart attacks occur because an artery is completely blocked. However, Samani says this is one end of a spectrum of possibilities. The reason you get a heart attack is that the inner lining of the artery breaks down, which exposes the underlying cholesterol plaque to the flowing blood, allowing a clot to form which blocks the artery. In gradual heart attacks, he says, the artery is only partially blocked, but then the clot might go downstream and block a smaller artery, so many can feel chest pain and then it settles as the clot breaks down and breaks away. An ECG machine may not detect anything wrong, further delaying treatment.
Apart from acute chest pains and sharp arm pain (usually in the left arm), symptoms include chest tightness, tingling fingers, jaw pain, stomach or back pain, breathlessness and indigestion, according to Philippa Hobson, a senior cardiac nurse at the British Heart Foundation. It may seem bizarre to feel pain in seemingly unrelated places, says Samani, but the nerves that send heart pain to the brain also supply the jaw and the left arm and so on the brain cant distinguish where it is coming from. The advice is to call 999 or an ambulance. Particularly as you get older, err on the side of caution, Samani says.
However, even if you are armed with the symptom list, if you are not expecting a heart attack, you, or a doctor, will be likely to attribute experiencing any of them to another illness, or even a panic attack. The thing to look out for, Samani says, is something you have never felt before. Walker says that, when his arm went numb, it was distinctive and felt alien. Weve all had our arm go to sleep now and then. It wasnt like that. It felt as if I didnt have an arm any more.
However, even as he was being transferred to another hospital for surgery, having had an aspirin and some rest, he was surprised at how well he felt. I was starting to feel embarrassed, expecting they were going to take me there with all this fanfare and it would just be indigestion, he says. But if he hadnt visited A&E when he did, I probably would have gone into cardiac arrest.
Doctors still dont know what caused Walkers heart attack. He doesnt smoke or take drugs, although his BMI at the time was just within the obese range. Since his recovery, he has lost 25kg (4st) and taken up cycling. He considers surviving his heart attack the best thing that ever happened to me.
Read the original post:
Would you recognise a gradual-onset heart attack? - The Guardian
- Cardiac Nursing Nursing Schools - RNtoMSN - Find Top Masters in Nursing Programs ... - April 13th, 2018 [April 13th, 2018]
- Associate Degree Nursing Physiology Review - April 18th, 2018 [April 18th, 2018]
- Cardiac Nursing Nursing Schools - Find Top Masters in ... - April 26th, 2018 [April 26th, 2018]
- Cardiac Nursing | Children's Hospital of Philadelphia - April 27th, 2018 [April 27th, 2018]
- Interpret EKGs Strips Like a Boss! (ekg interpretation for ... - May 12th, 2018 [May 12th, 2018]
- Chapter 36: Cardiac Disorders Nursing School Test Banks ... - May 18th, 2018 [May 18th, 2018]
- Cardiac Nursing - 9781416029342 | US Elsevier Health Bookshop - May 28th, 2018 [May 28th, 2018]
- Cardiology and Cardiac Nursing - July 3rd, 2018 [July 3rd, 2018]
- Cardio 2018 | Cardiology Conferences | Cardiac Nursing ... - July 30th, 2018 [July 30th, 2018]
- Nursing Care Plans for Decreased Cardiac output - July 31st, 2018 [July 31st, 2018]
- Cardiovascular Nursing Education Associates - October 14th, 2018 [October 14th, 2018]
- How to Become a Cardiac Care Nurse - Salary ... - December 3rd, 2018 [December 3rd, 2018]
- Cardiac Nursing | Become a Cardiac Nurse or Advance Your ... - December 3rd, 2018 [December 3rd, 2018]
- Cardiology | How to become a Nurse Practitioner - December 7th, 2018 [December 7th, 2018]
- Cardiac Nurse: Career Education for This Nursing Profession - December 16th, 2018 [December 16th, 2018]
- Decreased Cardiac Output - Nursing Diagnosis & Care Plan ... - December 16th, 2018 [December 16th, 2018]
- Cardiac Nursing at the CICU at Children's Hospital of ... - December 16th, 2018 [December 16th, 2018]
- Cardiac Care Nurse Careers & Salary Outlook - 2018 ... - December 16th, 2018 [December 16th, 2018]
- Cardiac Vascular Nursing Certification (RN-BC) | ANCC - December 22nd, 2018 [December 22nd, 2018]
- Cardiac nursing - Wikipedia - December 23rd, 2018 [December 23rd, 2018]
- Cardiac Nurse Salary and Job Description | Cardiovascular ... - December 23rd, 2018 [December 23rd, 2018]
- Cardiovascular Nursing | CNS Careers & Education - December 23rd, 2018 [December 23rd, 2018]
- Cardiac Nursing Nursing Schools - RNtoMSN - December 23rd, 2018 [December 23rd, 2018]
- Nursing Events - Emergency Medicine and Acute Care - January 16th, 2019 [January 16th, 2019]
- Nursing Journals Impact Factor List | Nursing Open Access ... - March 6th, 2019 [March 6th, 2019]
- Cardiac-Vascular Nursing Exam Review - Overview | Online ... - March 8th, 2019 [March 8th, 2019]
- Everything You Need to Know About Cardiac Nursing ... - March 8th, 2019 [March 8th, 2019]
- Decreased Cardiac Output and Ineffective Cerebral Tissue ... - March 17th, 2019 [March 17th, 2019]
- Free Cardiac Vascular Nurse Exam Review - Test Prep - March 30th, 2019 [March 30th, 2019]
- Cardiac Nursing Careers & Salary Outlook - 2019 ... - April 17th, 2019 [April 17th, 2019]
- Cardiology Nurse: Salary, Job Duties and Requirements - April 17th, 2019 [April 17th, 2019]
- Cardiac Nurse Practitioner - Nursing License Map - April 17th, 2019 [April 17th, 2019]
- Cardiac/Vascular Nurse Exam Practice Test (2019) - Mometrix - April 17th, 2019 [April 17th, 2019]
- Cardiac Nursing - Nursing Link - April 17th, 2019 [April 17th, 2019]
- 2019 Cardiac Nursing Conference - eventbrite.com - April 17th, 2019 [April 17th, 2019]
- Role of the Cardiac Nurse | Chron.com - April 17th, 2019 [April 17th, 2019]
- Cardiac SOAP Note - nursing notebooks - April 24th, 2019 [April 24th, 2019]
- Nursing Assessment of the Cardiovascular System - May 17th, 2019 [May 17th, 2019]
- Bayshore Oktoberfest Celebration to Benefit New Emergency Care Center - Newswise - September 23rd, 2019 [September 23rd, 2019]
- Chick-fil-A Employee Performs CPR, Saves Stranger's Life: 'God Placed Me' There - Christianheadlines.com - September 23rd, 2019 [September 23rd, 2019]
- IoT Medical Devices Market 2015 Global Trend, Segmentation and Opportunities Forecast to 2023 - OnYourDesks - September 23rd, 2019 [September 23rd, 2019]
- Beats & Rhythms offers heart disease support for families - The Spokesman-Review - September 23rd, 2019 [September 23rd, 2019]
- With Assisted Living Pickups, Symphony Post-Acute Targets Wider Swath of Care Continuum - Skilled Nursing News - September 23rd, 2019 [September 23rd, 2019]
- Gastrointestinal tract 5: the anatomy and functions of the large intestine - Nursing Times - September 23rd, 2019 [September 23rd, 2019]
- Chick-fil-A employee in Calif. helps save man's life - WPTV.com - September 23rd, 2019 [September 23rd, 2019]
- Business Notebook: SEMO expands public radio reach, local church gets new name - Southeast Missourian - September 23rd, 2019 [September 23rd, 2019]
- Balancing Risks, Rewards of Targeting Higher-Acuity Residents in Skilled Nursing - Skilled Nursing News - September 23rd, 2019 [September 23rd, 2019]
- Yorkshire trust's deputy leader takes on nursing director role - Nursing Times - September 23rd, 2019 [September 23rd, 2019]
- Rural ERs see fallout from national nursing shortage - Roanoke Times - September 23rd, 2019 [September 23rd, 2019]
- Peanut butter and cardiac arrest: Diabetic inmate at Holding Center dies - Buffalo News - September 23rd, 2019 [September 23rd, 2019]
- THE BOOKWORM SEZ: Nurse explains ABCDEs of treating people - Goshen News - September 23rd, 2019 [September 23rd, 2019]
- Heartbroken family's tribute to 'brilliant dad' who died choking on food - Hull Daily Mail - September 28th, 2019 [September 28th, 2019]
- Community Rallies For Parsippany Mom Who Had Open Heart Surgery Month After Birthing 4th Baby - Daily Voice - September 28th, 2019 [September 28th, 2019]
- A look at the 40 inmates who have died at Santa Rita Jail in the last five years - KTVU San Francisco - October 2nd, 2019 [October 2nd, 2019]
- Global Cardiac Holter Monitor Market to Witness Heightened Revenue Growth During the Forecast Period 2018 2025 - Space Market Research - October 2nd, 2019 [October 2nd, 2019]
- Seahawks Support Crucial Catch Activities For Cancer Awareness And Early Detection In Collaboration With Virginia Mason, CHI Franciscan - Seahawks.com - October 2nd, 2019 [October 2nd, 2019]
- Former nurse died after accidentally taking paracetamol overdose - Isle of Wight County Press - October 2nd, 2019 [October 2nd, 2019]
- Earn More With Ancillary Services: 10 Things to Know - Medscape - October 2nd, 2019 [October 2nd, 2019]
- Medical Beds And Chairs Market to Record an Impressive Growth Rate During Forecast 2018 2026 - Space Market Research - October 3rd, 2019 [October 3rd, 2019]
- Therapy Strategies Begin to Shift Post-PDPM as Genesis Lays Off 5% of Rehab Staff - Skilled Nursing News - October 3rd, 2019 [October 3rd, 2019]
- Improving inpatient care with MHS GENESIS - Stripes Japan - October 3rd, 2019 [October 3rd, 2019]
- Alkermes Presents New Health Economics and Outcomes Research on Patients With Schizophrenia and Bipolar I Disorder at 2019 Psych Congress - PRNewswire - October 7th, 2019 [October 7th, 2019]
- 16 years fighting breast cancer takes its toll, but Gainesville couple perseveres - Gainesville Times - October 7th, 2019 [October 7th, 2019]
- Irishman in Australia: It wasnt part of the plan to end up in the emergency department - The Irish Times - October 7th, 2019 [October 7th, 2019]
- North America Smart Patient Monitoring Device Market Projected to Worth a value of USD 3729.6 Million by 2027 - Space Market Research - October 7th, 2019 [October 7th, 2019]
- Its Very Unethical: Audio Shows Hospital Kept Vegetative Patient on Life Support to Boost Survival Rates - ProPublica - October 7th, 2019 [October 7th, 2019]
- Letter: Why force qualified nurses out the door? - Greenville News - October 7th, 2019 [October 7th, 2019]
- Saeed Ghani opens 10th Chest Pain Unit of NICVD at New Karachi - UrduPoint News - October 16th, 2019 [October 16th, 2019]
- Faculty Highlights: Recent Grants and Awards | Now - Drexel Now - October 16th, 2019 [October 16th, 2019]
- Learn to save a life - Kent Online - October 16th, 2019 [October 16th, 2019]
- A Kansas Judge With No Law Degree Holds The Futures Of City Residents With Medical Debt In His Hands - Kaiser Health News - October 16th, 2019 [October 16th, 2019]
- It's Very Unethical: Audio Shows Hospital Kept Vegetative Patient on Life Support to Boost Survival Rates - Mother Jones - October 16th, 2019 [October 16th, 2019]
- Site-of-Service Medicare Reimbursement Led to More Hospital Testing - RevCycleIntelligence.com - October 16th, 2019 [October 16th, 2019]
- Englewood Health, one of last independents in region, to merge with Hackensack Meridian - NorthJersey.com - October 16th, 2019 [October 16th, 2019]
- Unions for Sacred Heart nurses and hospital workers schedule strike votes - The Spokesman-Review - October 16th, 2019 [October 16th, 2019]
- These are the 10 best nursing homes in Pennsylvania - PennLive - October 20th, 2019 [October 20th, 2019]
- Surgical nurse who helped with the 'Baby Fae' baboon heart transplant - Redlands News - October 20th, 2019 [October 20th, 2019]
- The 'Angel of Death' Who Killed the Children She Was Supposed to Save - VICE UK - November 1st, 2019 [November 1st, 2019]
- Nurse rewarded for 'beautiful' sensitivity and compassion as a student - Nursing Times - November 1st, 2019 [November 1st, 2019]
- Nurses and hospital workers at Sacred Heart and other hospitals across the state are poised to go on strike - Pacific Northwest Inlander - November 1st, 2019 [November 1st, 2019]