A reader has a heart attack

A reader from Wichita Falls, Texas, sent me this email and I have his permission to post it.

Back on the night of 11/12 March, I went to bed about 11:00 p.m. after helping a home supplies tech move a refilled liquid oxygen container into my son’s old bedroom. I’d been on home oxygen about two weeks after three months of the “North Texas Lung Crud,” four courses of antibiotic from azithromycin to levofloxin and one hospitalization for COPD exacerbation. The container was ultra-heavy, and I noticed my neck/shoulders had felt some strain.

At 2:00 a.m., I woke up with a tremendous pain across my back between my shoulder blades. I went in, used the bathroom, and my wife, who was still up and in the kitchen, asked me if I was okay. I told her “yeah, just some muscle pain.” However, as I went back into the bedroom, I noticed my throat on both sides of my jaw was burning, like I had infected eustachian tubes. My wife was prescribed a bottle of liquid nitro a year or two ago when her doctor thought she might have angina. I sat down on the bed, and took a spray under my tongue. Immediately, I broke out into a copious sweat. I thought that was strange, but after a minute or so, some of the pain in my back decreased. That’s when I suddenly thought, “Uh-oh!”

I called my wife to bring me an aspirin. I had a bottle of generics sitting at the back of our pharmacopia closet, and she brought me one with some water. I took it, and she really started worrying. She says I was sweating rivers, and my normally greenish/brown eyes had turned bright blue. She helped me into the living room, because I was still kidding myself. I told her I was going to sit with my back against the heating pad. She went back in, grabbed my oxygen tubing, and hooked me back up to my 2-liter flow. After about a minute of realizing the heating pad wasn’t helping, I told her to call 911, because I thought I might be having a heart attack. She hit me with two more sprays of nitro, then called 911.

The EMTs got there in about 3 minutes from the station 4 blocks away. One took my BP, saw it was 70/50, and told his captain “I don’t like this!” They connected me to a 6 liter flow, and the ambulance got there in a couple more minutes. My wife, meanwhile, did the best thing she could do. She called the 700 Club prayer line, and put me on a nationwide prayer chain. The ambulance hauled me immediately to United Regional here in Wichita Falls, where the ER resident came in and informed me I was having a heart attack. Two cardio techs grabbed my stretcher after one of the nurses plugged in a Foley (Damn! I hate those!) and hauled me to the top floor to the new cath lab. The cardiologist came in a few minutes later, and told me I was having a massive heart attack.

He later told my wife that at that moment, he didn’t think he’d be able to save me. One tech tried to give me some baby aspirins, and I told him I’d already taken a full-strength aspirin at the house. At that news, the cardiologist yelled, “Good! Let’s go!” They went femorally and got two stents in on my right side. They plan to do another on my left in a couple of weeks.

My regular physician, whom I visited three days later, says that if I had to have a heart attack, I had everything going for me. Asprin, nitro, oxygen and prayer. I’ve been preaching to all my co-workers here now about the importance of taking an aspirin if they even suspect something wrong, and having an emergency-use nitro supply available if they can afford it. I think some of them are finally getting the message that heart attacks DO happen, even to mid-50′s types like me. Hope you can share this with some of your readers, and that they’ll listen.

Okay, done, and here’s to a speedy recovery!


Comments

  1. That’s excellent. He had everything but the morphine at his disposal.

    M.O.N.A.—morphine, oxygen, nitro, aspirin.

    Of course that info came from ER (ya know…the T.V. show!), b/c I haven’t hit any clinical rotations yet.

    I couldn’t find that mnemonic on medicalmnemonics.com, but I found:

    DOGASH–Diamorphine, Oxygen, GTN spray, Asprin 300mg, Streptokinase, Heparin

    Close enough.

    I hope he has a speedy recovery!!!

  2. THE order should really be

    Aspirin, oxygen, nitro/morphine, betablockers, but that doesn’t make a nice mnemonic.

    The aspirin is MOST EFFECTIVE if CHEWED, rather than swallowed because it is absorbed through the mucus membranes. In emergency situations, particularly if the patient is experiencing GI upset along with their MI, GI absorption is variable.

    Aspirin alone has been proven to be AS EFFECTIVE as throbolytics alone, and there fore should be given immediately upon the slightest suspicion that your patient MAY be having an MI!

  3. Have you actually read that “chewed ASA is better” somewhere? I hear it from time to time, and frankly have trouble believing it.

    Let’s remember, the ASA recommendation came from a study that found a benefit for heart disease if given within, I believe, the frst 12 hours.

  4. OK, I answered my own question! The answer is: 7 minutes difference!

    http://tinyurl.com/3mu5r

    So, there you are.

  5. I just hope he thanked the cardiologist as much as he thanked god.

    seems one helped a little more than the other.

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