Editor’s Letter

Diana Swift
Editor-in-Chief
editor@canadian-health.ca

In my view, editors should not generally use their columns as a forum to write about their personal experiences. But nowadays, it seems, this is a journalistic principle honoured more in the breach than the observance. So I am going to tell you about how my beloved sister Susan—smart, lovely, slender, wealthy, fit and just turned 60—died suddenly this summer of cardiac arrest after suffering several heart attacks within a few hours. Unbeknownst to me—she was a private person and in some ways we were more competitors than confidants—Susan had been complaining of worsening shortness of breath all last summer. This she put down to a particularly bad allergy season. In the final days of August, she developed a constant pain that radiated between her chest and jaw. She put the jaw pain down to her habit of grinding her teeth in her sleep and the chest pain to pulled muscles from heavy end-of-season housework.

Photo : Susan Ashukian

On a sweltering Labor Day in Cincinnati, Ohio, refusing to give in to her discomfort, Susan made a major shopping excursion for fall clothes. She lunched at a nice restaurant with her husband and that night ordered in a special Asian Fusion dinner. But as she got up from the table, she complained of feeling faint. On her way to have a bath, Susan collapsed and could not be revived, dying three hours later from multiple acute myocardial infarctions. These, said the ER physicians, were almost certainly brought on by a blockage in the arteries that had been restricting blood flow to her heart for the past several days.

As in my sister’s case, a first heart attack is more likely to be fatal in a woman than a man, and women are more likely to die in the first year after an attack. Yet in females, the signs of an impending infarction may be more vague and subtle, and feel more like a bad case of indigestion than the elephant-on-the-chest squeeze that can cause a person to drop like a stone. Still, as with men, chest pain or discomfort is the most common indicator of heart disease in women.

If Susan had been aware of the warning signs of an attack, especially women’s subtler clues, she could have gone to a hospital early and had therapy to dissolve obstructive blood clots and perhaps angioplasty to open up her coronary arteries. So I urge both sexes to get acquainted with these 10 alarm signals of an impending infarction.

• Pain from the centre of the chest that spreads down
one or both arms and up to the shoulders, back, neck or jaw
• Chest pain that feels like heaviness, burning, squeezing, tightness, pressure or crushing
• Chest pain or discomfort that is brought on with exertion and disappears with rest
• Sudden chest discomfort that persists even with rest
• Difficulty breathing or shortness of breath
• Indigestion, nausea or vomiting
• Cold sweats or cool clammy skin
• Pallor
• Fear or anxiety
• Denial: a refusal to admit anything is wrong

Though their most common symptom is chest pain, women are somewhat more likely to experience other symptoms on this list, particularly shortness of breath, nausea or vomiting and pain in the back or jaw. If you (or someone you’re with) show any of these signs, call 911. The affected person should immediately sit or lie down to rest until emergency help arrives. If Susan had followed this advice, I am sure she would be alive today.