Gripping chest pain - heart attack or just stress?

It’s been a stress-filled period for me, some of it caused by external factors and probably most of it self-inflicted. I admit I’m pretty anal. I worry about practically everything, from having enough gas in the car to fretting about being late for a meeting. Looking back now on the few episodes when I experienced excruciating chest pain, they were all stress-related. I try to tell myself to take it easy, practise deep breathing and think calming thoughts, but in reality I’m bracing myself for the next episode. The thing is, I still don’t know whether it’ll be another stress attack or an actual heart attack.

I was driving home on the highway when it happened again recently, with my son, B, asleep in the passenger seat. The same gripping chest pain that seemed to envelop my whole upper body. It hurt when I took a breath so I just breathed shallowly, I thought of pulling over but told myself that if it were similar to the two episodes I had before, the pain would ease off eventually. So I timed the whole episode (I’m trying not to call it an attack) and it lasted just about ten minutes.

I did pull over and told B what was happening. He wanted take me straight to the hospital but as the pain was easing off, I just said let’s head home and see how it goes. The rest of the night was pain-free, though I did stick a baby aspirin under my tongue just in case.

I saw a cardiologist the next day who asked me a whole bunch of questions about my general health and more pointed ones about the episode that happened the day before. Did the pain travel anywhere else from the chest? Did my jaw ache? Was I perspiring? Did I feel nauseous? The answer I gave to all of the above was no. It was just excruciating pain. The tests he put me through didn’t indicate anything , but he did tell me that the answers I gave in a situation like this would be more telling than anything the machines showed.

He just scratched his head and said basically that women are strange. While men have more straightforward heart attacks, the symptoms women display are more insidious. While more women than men suffer heart attacks (who knew?), symptoms like indigestion and tiredness are probably attributed to other health problems, and women who have these symptoms are less likely to seek immediate medical attention.

So it’s not always a crushing chest pain that’s signalling a heart attack. Results from my blood test showed an increase in my cholesterol level (I already knew that would be the case) but luckily the doctor didn’t recommend any medication for it. He just told me to up my sessions at the gym from the 2-3 times I told him I was having (I lied) to 4-5 times a week.

Of course B was very concerned but I assured him it was all to stress. After hitting the big six-oh, I’m expecting my health to deteriorate somewhat and I’m trying to do all I can to stay healthy. Ok, I have to exercise more regularly and eat more healthily. Apart from that, I don’t know what else I can do. Worry less? That’s a tall ask.

I did make a note of all the symptoms women can possibly have, and the cardiologist did say that the next time I have such an attack for more than ten minutes to go to the hospital immediately because time is of the essence when it comes to saving someone when they’re having a heart attack. Now I know I’ll start worrying - do I drive myself to the hospital, call for an ambulance (notoriously slow), or call uber? Ok, ok, take deep, calming breaths!

So this is my list of symptoms to be aware of and watch out for.

Most common heart attack symptoms for men and women:
• Discomfort, tightness, uncomfortable pressure, fullness, squeezing in the center of the chest lasting more than a few minutes, or comes and goes

• Crushing chest pain

• Pressure or pain that spreads to the shoulders, neck, upper back, jaw, or arms

• Dizziness or nausea

• Clammy sweats, heart flutters, or paleness

• Unexplained feelings of anxiety, fatigue or weakness – especially with exertion

• Stomach or abdominal pain

• Shortness of breath and difficulty breathing

Heart attack symptoms found to be more common in women:
• Pain in the arm (especially left arm), back, neck, abdomen or shoulder blades

• Jaw pain

• Nausea and vomiting

• Overwhelming and unusual fatigue, sometimes with shortness of breath

• Light headedness or sweating