Maybe Symptoms of a heart attack but not right now. ER anyway?

October 28, 2022 7:53 PM

I have been for the last week, having symptoms of what could be a heart attack. The problem is, I'm mostly feeling fine right now AND there are other health issues that explain some symptoms, which make the other ones I am experiencing not really enough to think heart attack. I know the answer is probably going to be to go to the ER, but I'm not sure what to say because I'm feeling ok right now. Especially given I feel like I probably am not having a heart attack.

46yo female with no heart issues prior. I have been feeling like crap since the end of last week, and had something happen earlier today that had me looking up symptoms and google showing most results for "hey, this seems like a heart attack, maybe you should go to ER." The problem, of course, is looking for medical advice on google, but I was having kind of non-specific wtf symptoms all week.

I walked up 11 flights of stairs - I do 7 flights on the regular though lately its been tough, but I kinda attributed it to either being out of shape or still recovering from covid that I got again mid september. The 11 flights I do in a building on campus to stretch my legs, though I haven't this semester at all. I was winded by the top but wasn't too surprised, however, felt faint at the top and as I was coming down (the kind of dark around the edges but didn't actually feel like I was going to pass out. Broke out in a bit of a sweat, stopped and waited until it passed. Continued down, walked to the gym I was heading to and started to feel kinda sick; then got cramps, almost like period cramps.

In the gym locker room, I had to sit down, my legs were shaking, the cramps got worse, and I broke out into a sweat just sitting there. My period just finished a couple days ago, so unless I'm getting. The legs maybe made sense because in addition to being more stairs than my daily, I had lifted weights two days ago, it was honestly the best session since I got covid though I cut it short because I was feeling weak.

So I googled. The search results were primarily heart attack. And I had to admit, I'd been having weird ass symptoms that I thought were unrelated that all kinda spell out heart attack. I have some radiating jaw pain on left side, though I do have a tooth that needs to be crowned and it acts up sometimes. I have some pain with my left shoulder and arm, though I have a tear and tendinopathy in that shoulder and it acts up sometimes and I thought thats what it was. I have been fucking tired and fatigued, but also stressed and not sleeping well, so that could be all it is. I have had those weird episodes of breaking out and sweating, or sweating more than normal with minimal exertion. But I'm a woman in my 40s and probably in perimenopause. I've felt just kinda nauseous the past couple days, but sometimes I just do. I have been feeling kinda faint, but I thought it was probably dehydration as I've been drinking less on campus. Indigestion, though I sometimes do and I've been drinking more coffee lately.

But I had to admit, when I looked at it without the reason I thought why, I did have some of the common symptoms for women - left side jaw, shoulder and arm pain intermittently, breaking out in a sweat, nausea, feeling faint and dizzy, indigestion, feeling fatigued and short of breath... I think that's everything but the chest pain/squeezing, which I understand women don't get.

So I think I have to have evaluated for heart attack, but I'm not experiencing those symptoms right now. Do I still go to the er or wait for my PCP on Monday? If er, what do I say? This feels like a terribly dumb question to ask but I don't know.

posted by [insert clever name here] to Health & Fitness (23 answers total)

Response by poster: Should read "which I understand women don't always get."
posted by [insert clever name here] at 7:54 PM on October 28, 2022

I would go to the ER. When my mom had a 100% blocked coronary artery her only symptom was vomiting and feeling like she was going to die. Someone with the symptoms you report (not nec you, just saying) could have a less solid blockage and still urgently need a stent. Please go for peace of mind. It’s not a twisted ankle, this is your heart.

Edit: sorry she felt nauseous, vomited, and sweat. Women’s symptoms are different than men’s.
posted by cotton dress sock at 8:00 PM on October 28, 2022 [4 favorites]

If you think it might be a heart attack, you don't wait out the weekend to see a doctor. But...yeah...take a book or something. Describe your symptoms to the triage nurse. Leave out the part about consulting Dr. Google.
posted by praemunire at 8:00 PM on October 28, 2022 [4 favorites]

Go now. I’ve been in a similar situation and went to the ER. It ended up being nothing (likely anxiety), but if I hadn’t gone I sure as hell wouldn’t have slept that night.

I kept apologizing to the doctors for wasting their time and trust me, they did not care at all.

If you go and it ends up being nothing, the worst that can happen is you spend the night in the ER. If it is something and you don’t go, then the alternative is considerably worse.
posted by krunk at 8:01 PM on October 28, 2022 [3 favorites]

Yes, ER, but first take an aspirin if you have aspirin available ... they recommend you chew and swallow one 325 mg aspirin if you think you are having a heart attack.
posted by gudrun at 8:16 PM on October 28, 2022 [8 favorites]

Go to the emergency room. I saw a study recently that many women don't go to the ER to get checked out because they've been told a heart attack is the worst pain they've ever felt, and many of them felt the pain did not measure up to a menstrual period so blew off their symptoms.
posted by Eyebrows McGee at 8:22 PM on October 28, 2022 [22 favorites]

Oh, just saw you recently had Covid - definitely tell the ER folks about having had Covid - it can cause heart complications.
posted by gudrun at 8:22 PM on October 28, 2022 [18 favorites]

For whatever it's worth coming from a former EMT, please go to the hospital tonight.
posted by jameaterblues at 8:24 PM on October 28, 2022 [11 favorites]

IANNYD, but I have been in emergency services for a long time. If you called 911, we’d put you on the monitor and take a look-see with the caveat that bloodwork is really the gold standard. If you didn’t take a ride, I’d suggest that you transport POV to the ER. You’d be surprised that a lot of folks who don’t call until the last minute, or the ones whose friends/family call for them, are the ones we suggest take a ride.

All this to say, in most systems, you may not get seen any faster via EMS. However, if there is something going on, you will get bumped up in triage. If you don’t feel comfortable driving or it’s a considerable distance, please don’t hesitate to call 911 and request that they head off to your abode.
posted by sara is disenchanted at 8:29 PM on October 28, 2022 [7 favorites]

Should have tacked this on to my answer above. Just cause it ain’t a heart attack doesn’t mean it’s not *something*. You can always follow up with your GP Monday after you get checked out at the hospital.

And here’s the thing; say it is dehydration, right? As an example. They will do an EKG and bloodwork and start a line. Word. Now you got a bag or two of fluid and you’ll feel right as rain. No loss in going in.
posted by sara is disenchanted at 8:34 PM on October 28, 2022 [8 favorites]

When you go to the ER, your first paragraph after the fold ("46yo female with no heart issues prior...") is precisely what you tell them, except with a summary of what happened today filled in. It's a very reasonable story that conveys why you're concerned right now specifically and that this has been going on for a while under various circumstances, so hopefully they'll be less likely to brush it off as "just" this/that/the other thing.
posted by teremala at 8:35 PM on October 28, 2022

I spent nearly a month this past July/August in a prolonged and increasing panic because I was afraid I was having a heart attack and I was also afraid of inconveniencing myself/others/etc by going to the hospital with many of the same symptoms you are reporting (+chest pain). I finally went to the ER because a family member dragged me, and we waited, and they took blood and multiple EKGs and xrays and . . . it was anxiety and acid reflux (and perimenopause+fibroids) but it was absolutely 100% worth it to just go and know for sure. Because by the time I did I had made myself miserable and sick with worry.

Don't wait. Go.
posted by thivaia at 8:55 PM on October 28, 2022 [4 favorites]

The advice here is to go to the ER, but you feel fine. I can relate, I also live in the US.

If you have insurance, you definitely probably have an advice nurse. If you don't have insurance, there is probably still an advice nurse you can call. If you still feel uncertain, call the advice nurse. The advice nurse can tell you to go to the ER.
posted by aniola at 9:00 PM on October 28, 2022 [3 favorites]

Response by poster: Thanks everyone, I’m in the ER waiting room now.
posted by [insert clever name here] at 9:36 PM on October 28, 2022 [96 favorites]

OP, I’m glad to hear you went in.

Even if at the moment they can’t see anything, you should get yourself seen for follow up, preferably by a specialist. My PCP completely dismissed my cardiac concern about 2 months out from covid, but I went in to see a cardiologist anyhow (after hemming and hawing because the pcp was so sure I had no issue). The cardiologist had me do a 24hr monitor and indeed something *is* up, and I will have to go on a drug and get more tests. So I’m pretty glad I persevered.
posted by nat at 9:39 PM on October 28, 2022 [6 favorites]

Also, when you get seen, don't let them brush you off with "it's just Anxiety" - make sure they give you a Electrocardiogram (ECG or EKG) to be sure.

The number of women who have ACTUAL heart attacks brushed off in Emergency Departments as "just Anxiety" is terrifying and enraging.

(And yes, it is mainly women, it happens MUCH LESS OFTEN to men.)
posted by chariot pulled by cassowaries at 11:34 PM on October 28, 2022 [12 favorites]

Couple years back I drove my friend's mother to hospital because she thought she might be having a heart attack. The hospital took her seriously, checked her out thoroughly, and found that what she'd experienced was probably a panic attack, which can present with very similar symptoms. They hooked her up with some resources for helping prevent and manage panic attacks. She's better off now than she would have been if we hadn't gone.

I'm glad you went. I'm sorry your country's medical funding systems are so unfit for purpose that whether or not to go was ever even an issue for you.
posted by flabdablet at 1:46 AM on October 29, 2022 [1 favorite]

I'm happy to hear you went to the ER. As Gudrun mentioned, covid infection increases the risk of cardiovascular disease: https://jamanetwork.com/journals/jama/fullarticle/2789793
posted by mydonkeybenjamin at 5:52 PM on October 29, 2022 [1 favorite]

Anecdote, but my friend was feeling kinda funny, wondered if it might be a heart attack. Basically tossed a coin on whether to go to the hospital or not given he had his kids with him. They ran a pulse oxygen test on him at reception and basically yelled "surgery now" and he had just enough time to call his ex to get to the hospital before they took him in.

The surgery was simple, but they said if he'd waited a few hours longer he'd have died. Apparently an uncommon condition that hits reasonably healthy, younger people, especially women, hardest.
posted by Pink Frost at 9:22 PM on October 29, 2022 [2 favorites]

Just another person wanting to say good decision going to hospital.

Last fall i was ambulanced from work to ER due to a heart attack symptom check list and felt terribly anxious I was wasting the ambulance and hospital's time, especially during covid...

It was not a heart attack (gall bladder attack). But the medics and doctors took it very seriously. I got treatment and was kept in until pain was resolved and tests determined whether i needed surgery (i didnt). When released I was given clear instructions to return if similar symptoms emerged again, and to see my gp for referrals to additional tests.

So... I was so worried I had it wrong about the heart attack, but the doctors also didnt know it wasnt a heart attack until they tested me

And in the end it was still the right place to be even though it wasn't a heart attack. Which somehow had never occured to me?

Wishing you all the best, whatever the result.
posted by chapps at 1:48 AM on October 30, 2022 [2 favorites]

Glad you went to the hospital. If it's any consolation, I've been in your shoes a couple times, and every time I went and it was nothing (and felt bad for wasting everyone's time) they've always told me they'd always rather I come in to be checked out than not. It's literally the triage nurse's job to make the assessment of how urgently I need care and they're good at it, so let them do it.
posted by cgg at 10:38 AM on October 30, 2022 [1 favorite]

Glad that you went on to the ER. As a supporting point, when I, a 44 year old woman, was having issues with chest tightness last year, I called my GP about an appointment. His office said, nope - just go straight to the ER. So it's at least somewhat likely your doctor would have also.
posted by bizzyb at 12:19 PM on October 30, 2022 [1 favorite]

Just hoping you'll update us when you have some answers!
posted by woodvine at 10:45 AM on November 3, 2022 [3 favorites]