A year ago, on the morning the Brexit referendum results came through, I was attached to a heart monitor in A&E.
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The previous night, I’d been watching the TV coverage with my husband Andrew in the village pub in Dorset, tucking into crisps. But, as the Sunderland results came through, I began to feel unwell. It felt like acid reflux and my chest was aching, but in a strange, compressed sort of way.
I needed air. I went outside and sat on a bench. The tops of both my arms began to feel numb, a kind of ‘fizzy’ sensation. It didn’t feel right, but it never crossed my mind it was a heart attack.
Women's heart attacks and misdiagnosis
In the previous three months, one of my sisters had died of a brain haemorrhage, my father had passed away and my nephew had died in a fire. I have never known grief like it. I appeared calm and measured. I organised two of the funerals. I stood up at the front of a packed church to give two eulogies without a tear. But inside, I was racked with pain.
So, on the night of the referendum, with Brexit looking ever more likely (I was a firm remainer), I put my symptoms down to stress.
I walked home to relax on the sofa. Ten minutes passed, but no improvement. I decided to call 999. I apologised to the operator for possibly wasting the emergency services’ time but I knew what I was feeling wasn’t normal. Even when she mentioned a possible MI (myocardial infarction – another term for a heart attack), the seriousness still didn’t sink in.
Andrew returned from the pub, with eyes both on the Brexit drama unfolding on the TV and the one taking place on the sofa. His divided attention might seem a bit harsh, but I kept telling him I was fine.
Tests in the ambulance showed nothing to worry about, but I was taken to A&E to be monitored. At about 6am, I was told things were looking OK and I’d probably be home later that morning. But more tests followed and – this part is a bit hazy in my memory – the doctor said something about my troponin levels [proteins released into the blood during a heart attack] going off the scale. I’d need to be admitted to the coronary ward.
The word coronary went through me like a bacon slicer. Forget Brexit. This was really a matter of life and death. And me a reasonably fit non-smoking 55-year-old who had a well-balanced diet and limited family history of heart problems.
Subtle signs of women's heart disease
I was wheeled up to the ward, terrified. I don’t remember crying, though, until the consultant and medical students crowded round my bed and I recounted my recent catalogue of family horrors.
‘It sounds like it could be Broken Heart Syndrome,’ the consultant said – a temporary condition where your heart muscle becomes suddenly weakened by stress. It’s not a heart attack, but the symptoms are very similar.
I felt a bit pathetic. ‘You’re not invincible,’ reasoned Andrew.
I was booked in for an angiogram, my son Aaron arriving just before I went in, sobbing by my bedside.
It was surreal, lying back, looking at a screen and watching the dye go through my veins, as clear as radiating and beautiful tree branches. It appeared that no permanent damage had been done to my heart. I was sent home, having been told to rest and not drive for two months.
Some weeks later, I had a CT heart scan, an uncomfortable procedure I wouldn’t wish to repeat. When I went to see the consultant for the results, I was confident he’d tell me I’d had the rather romantic-sounding Broken Heart Syndrome.
He seemed to take for ever to read the report. He peered at me over his glasses; his desk suddenly seemed giant-sized.
‘You’ve had a small heart attack,’ he said.
‘Not Broken Heart Syndrome?’ I replied, stunned.
‘No, you had a heart attack. The scan shows there is some permanent damage to your heart muscle – maybe a small blood vessel was blocked.’
Did stress cause it? He couldn’t be sure but said it wouldn’t have helped.
I’m now on aspirin and statins for the rest of my life – and make sure I take plenty of exercise. I feel OK, but lucky to be alive. And I will always be thankful I listened to my instincts and called 999. Only you know how your body feels. If something isn’t right, it’s time to get help.
What is Broken Heart Syndrome?
It may sound like something a Jane Austen heroine would succumb to, but Takotsubo cardiomyopathy, to use the medical term, is very real. Severe physical or emotional stress – a big operation, perhaps, or the loss of a loved one – is thought to cause a surge in hormones, such as adrenaline, that stuns the left ventricle in the heart. It becomes weakened, causing chest pain and breathlessness, which can feel like a heart attack. Happily, this effect is temporary and the problem is unlikely to happen again.
Why heart attacks are different for girls
The classic heart attack symptom is severe chest pain, but Emily Reeve, senior cardiac nurse at the British Heart Foundation (BHF), says many women may not experience it.
The reason for this isn’t clear, but it means that women should be particularly wary of other symptoms, including:
1. Pain between the shoulders, radiating down the arms or in the neck or jaw. It may be very bad or just uncomfortable.
2. A reflux or indigestion type of discomfort.
4. Stomach pain.
5. Dizziness, shortness of breath and nausea.
The problem is that it may be harder to recognise these symptoms as something as dangerous as a heart attack. BHF research has found that women tend to wait longer before calling 999, reluctant to cause a fuss or wanting to avoid embarrassment if it turns out it’s not serious. They are also 50% more likely to be misdiagnosed. This can delay effective treatment and severely reduce a patient’s chance of survival.
Women – especially post-menopause – should heed the factors that increase their heart-attack risk, such as blood pressure and cholesterol levels. BHF recommends that all those over 40 should ask their GP for an NHS health check – coronary heart disease kills twice as many women as breast cancer.
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