Heart attack symptoms
Most heart attacks start slowly with mild discomfort, according to the American Heart Association. That's why it is particularly important to be able to recognize the warning signs of a heart attack. Here are some of the more common signs, and a few tips, according to the association:
¢ Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back.
¢ Discomfort in other areas of the body. Specifically, symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
¢ Shortness of breath with or without chest discomfort.
¢ Cold sweats, nausea or lightheadedness.
¢ A heart attack in women is somewhat more likely to produce the symptoms of shortness of breath, nausea and back or jaw pain.
¢ Not all of the symptoms have to occur for a heart attack to occur.
¢ If you can't positively rule out a heart attack, call 911 for emergency medical assistance.
l If available, always call an ambulance rather than driving to the hospital.
This was going to be the day.
It was Sept. 17 - a warm Monday that summer wouldn't quite let go of - and Lawrence Fire Chief Mark Bradford did something he normally doesn't do. He went home to eat lunch with his wife.
Mark sat in his kitchen and munched on a simple peanut butter and jelly sandwich, while he listened to his wife, Trish, speak about her latest efforts. She was training for a half-marathon.
Trish, by her own admission, is an exercise nut. Mark is ... well, he describes it this way: "I'm not the perfect gym rat."
That could be one way to put it.
It was not, however, how Trish chose to: "He hates exercise."
But something - maybe it was all the talk of training or maybe it was just a rush from the sweet jelly - but something put Mark in the mood that men sometimes get in. They see the bull and decide to go right after the horns.
"He told me he decided this was the day he was really going to do something about exercise," Trish said.
Then, he promptly did his best to drop dead.
Mark Bradford looks like a man of order.
Put his tall frame and broad shoulders in a perfectly pressed white shirt that serves as a stark, clean backdrop to the gold shield that he wears over his heart, and there's no doubt who leads the Lawrence-Douglas County Fire & Medical department.
In short, he doesn't look like the type of man who has to worry about dying of a heart attack over a leisurely lunch.
"I'm in fairly decent condition," Mark said. "I probably eat like most everybody else - not the best but not the worst. I don't smoke. I don't drink. You feel like you have a pretty good life."
But that's why Mark is sitting here today - 48 years into his life and 144 days after the ordinary lunch that almost was his last - talking to a newspaper reporter about an extremely personal event.
He wants people to know that a heart attack can sneak up on anyone.
It sure did on Mark, a 27-year veteran of the fire service who has spent many of those years as a paramedic and advocate for better heart care. In February, he had his annual fit-for-duty physical required for all firefighters. Because of a history of elevated cholesterol levels, he had a special cardiovascular exam as part of the physical. No problems were found.
None of that mattered, though, because on Sept. 17 Mark didn't just have a heart attack. He found himself on his back in his west Lawrence home sweating, suffering and worrying about a very specific type of heart attack. One that paramedics and doctors have long had a gruesome name for: A widow-maker.
Trish knew something was wrong.
No sooner had Mark gotten done making his exercise proclamation than he declared that he felt nausea. It just hit him all of a sudden. He'd felt fine all morning and wasn't having a particularly stressful day. But now he felt sick and said he was going to lie down.
Then, just seconds later, Mark called Trish back into the room.
"He was sweating profusely, and when he called me back in, he had an ashen look on his face," Trish said, describing two classic symptoms of a heart attack. "I knew there was something wrong. I just didn't know how bad it was."
But here's where 17 years of being married to a paramedic comes in handy. She knew she didn't need to know what was wrong. She just needed to call 911.
"I just tried to stay calm and think it through," Trish said. "That's what anyone should do. If it is just indigestion, great, but get them to a hospital and let someone else diagnose it."
Mark said his wife did exactly what she was supposed to.
"Always err on the side of critical," he said. "She did exactly what every good wife does. She told her husband exactly what to do. I don't know if I would be here if it wasn't for her being there."
But critical was no err in this case.
Trish remembers kissing her husband on the cheek, telling him she loved him and then leaving him alone to go let the paramedics in the front door.
When she arrived at the Lawrence Memorial Hospital emergency room, Mark already was hooked up to several machines and surrounded by doctors and nurses. Within minutes, Trish was handed a consent form to allow doctors to do an emergency operation to clear her husband's artery.
"I remember looking at the nurse and saying, 'You're going to do this now,'" Trish said. "At that point, I knew it was really bad."
But she didn't let it show. By all accounts, Trish was calm throughout.
"I thought if I stayed calm, that would help him stay calm," Trish said.
There were moments, though, that the crowds of people gathered at the hospital - doctors, nurses, concerned assistant fire chiefs and Trish's co-workers at the Lawrence Police Department - didn't see.
"That first night back at our house, when I went to bed, it hit me," Trish said. "That's when it hit me how life could have been so different."
Mark knew what was happening.
Yeah, that had both its good and bad points. He knew what to expect because he's been a paramedic on more heart calls than he can count. He could see, and follow along, with the treatment that was being done. His team was doing it just right.
"I was coherent through it all," Mark said. "Coherent as much as usual, anyway."
So he knew what to expect. But he also knew what to expect - good and bad points.
Mark knew, eventually, what type of heart attack he was having. He knew it was a widow-maker. His left coronary artery was completely clogged. Such a heart attack kills more than 90 percent of everyone it strikes. Mark had told crowds that statistic on several occasions.
Perhaps the only good thing about this particular type of heart attack is that it doesn't create much indecision. Mark and his paramedics frequently see people have heart attacks who don't recognize it until it is too late. They have an achy chest pain, perhaps with a back or neck ache. Maybe their arm is sore. They let the pain linger for a day or more before they get medical attention.
With a widow-maker, there's no mistaking the pain as something that will soon pass.
"This is the worst pain I had ever experienced," Mark said. "This is the only time I felt there was a possibility that I would not survive."
When he got to the hospital, his worries were confirmed. They immediately wheeled him into a special section of the ER reserved for the most critical of cases.
"I knew I wasn't going in there because I was a VIP," Mark said.
But then he caught a break. Life sometimes is about breaks.
The one that Mark likely always will remember is that a team of cardiovascular surgeons had just finished a procedure in the LMH Cath Lab. In other words, the team of surgeons Mark needed to save his life was already at the hospital and ready to begin work. He entered surgery 19 minutes after he arrived at the ER. He had three stents placed into his left anterior descending artery. It was during that surgery that Mark first gained some optimism that he would live to see tomorrow.
Like most patients having the heart procedure, he was partially conscious. Doctors kept asking him whether the pain was subsiding. That's one way they gauge whether their work to clear the artery is successful. At some point, several minutes into the surgery, Mark finally got to answer yes.
Mark knew what a doctor later told his wife.
"The doctor said it was just a matter of minutes before he was gone," Trish said. "If the surgeons hadn't already been at the hospital :''
These days, Mark sums up the break of a lifetime simply.
"In this case, I think the stars were just all lined up correctly, as they say."
Not all of life is about breaks, though. Some of it is just about hard work - the hard work of change.
That's how Mark would describe the process of rehabilitation. And he's honest in saying that he doesn't yet have it mastered.
"I'm probably not unique," Mark said. "I'm not a good patient."
Trish would agree.
She said that since the heart attack they've talked many times about his need to exercise more and to eat better. Trish said she had always fixed healthy meals but has taken it to a different level. She replaced ground beef with ground turkey, in many cases. And there are other changes she's not going to reveal here.
"I've made lots of changes that they don't know about," she said, referring to Mark and their 14-year-old son.
But she's not with her husband for every meal, and Mark admits that there have been times when restaurant receipts have given him away.
And then there is the exercise. Mark spent nine weeks in official cardio-rehab at LMH. Now, he has a set of exercises that he's supposed to be doing every day. Instead, he does them a couple times a week, he said.
"I'm still like anyone else. I have to physically schedule the time to exercise," Mark said. "It can be tough."
Can be tough on the person who has to watch it, too. Trish said she exercises more than ever to relieve her stress. She says she sleeps lightly any night that her husband goes to bed feeling a little ill with the flu or a cold. She says she prays for him.
But what she tries not to do anymore is nag about his rehabilitation. That doesn't mean she still doesn't encourage. She looks forward to nice weather when they can take long walks together.
She also prepares. She knows it could happen again. She took a CPR course to brush up on those skills. She's talked openly with their son, Zachary. Having a family history of heart problems is one of the risk factors for having a heart attack yourself. She and Mark have been discussing the purchase of an automated external defibrillator for their home.
But she also has realized that there's only so much she can do.
"He knows how I feel. He knows how Zachary feels," Trish said. "He's an adult, and he has to make these choices. I don't know what will get him to do it, but it is not anything I'm going to do. It has to come from him.
"But you also have to realize that it is not going to happen overnight. It is not easy. But he's working through these things himself.
"And I know he's going to get there."