Did I just have a mild heart attack or was it severe indigestion?

[jbmaddhouse]

Hi, I am a 34 year female.  I have been under very high amounts of stress and anxiety for the past 8 months.  On my dad's side, there is heart disease, high BP, heart attacks both in uncles, grandfather and grandmother on my fathers side.

Bare with me, I have been a bit paniced for about 3 hours now.  We sat down for dinner tonight, I made whole grain pasta, ground turkey meat sauce and I was drinking water.  Yes, I was starved and maybe I ate too much too fast.  I didn't even finish my meal.  After about 10 minutes in to the dinner, I had to sit back.  My chest felt like someone was sitting on me and I was very uncomfortable and had a feeling of being very full.

I broke out in to cold sweat, and ended up on the floor in the bathroom.  I ended up throwing up.  My entire back was throbbing and what is really odd, my ears were hurting so badly.  I couldn't figure out why my jaw and ears were hurting.  The pain in my chest became much more tighter.  I could hardly walk or sit still.  I kept going back and forth from the bathroom and the chair.  I hurried and chewed up 4 rolaids, but I think it made it worse.  I continued throwing up in the bathroom but only because it felt as though I had a softball in the middle of my breast bone.  It was such intense feeling.  Weird thing is, I had this happen about 4 months ago after eating the same type of meal.

I of course emptied my stomach with hopes that the pain would go away.  I layed in the lounge chair, freezing now.  I covered up and told my daughter I feel as though I just got ran over by a truck.  I had this pain for a little over an hour.  then the chest syptoms eased up.  I felt so worn down that I ended up falling asleep for about 45 minutes and I didn't hear one thing.  Now, I am panicing...did I have a heart attack?  Why was this so painful and long?   There is still a slight odd feeling between by breast bones...maybe the size of a gumball.  Of course, I am slightly dizzy and just really worn.  I have a high tolerance for pain and since I am home alone with my 3 children, I kept thinking I just have to get through this.

I called my husband and let him know what was happening...but he thinks is stomach related.

My heart is racing but I think I am stressing myself out even more.  Can indigestion come on that quick and that painful. Why the pain in the back and ears?

Please advise, I am alittle scared.

I just got my blood work back, my cholestoral is 244....a bit high but we are working on it.  I eat good..just can't stay away from the cheeses.

Thank you.

Rebecca

[erijon]

You are correct, the article comes to no absolute explanation, just conjecture. I wish I had the other link, the author's synopsis was a very interesting read in which he speculated that sudden inhalation of cold air causes a vasoconstriction reflex which has a larger effect on areas on the heart being supplied by collaterals based on their already extremely small size. What he said made perfect sense to me, but I'm easily swayed :)

[kenkeith]

Jon, the article states it cannot explain....some other specific effect of cold air inhalation on coronary vasomotion, perhaps affecting collaterals or coronary blood flow distribution, is suspected.

I was referring to the stimuli that can cause a heart attack by placing a high demand for blood/oxygen, however, pectoral angina is an indication there is a higher demand for oxygen than the heart is able to provide effectively.  My problem with understanding is why the system's need to keep the body warm not a consideration, as we know this condition is a draw on available blood/oxygen.  I don't read the body is kept warm, and the source of cold air is not due to cold weather, but apparently that is the case. Or I am missing the point! :)  

.

[erijon]

Ed is correct, that's the article. Towards the end it discusses the role of cold air;

"the inhalation of cold air, which may further evoke a reflex spasm or constriction
of the coronary arteries.19·20 In the presence of coronary artery disease, these
effects may lead to myocardial ischemia and malignant ventricular arrhythmia's."

This is not the link I'm looking for however. When I first read this, there was also a commentary attached by one of the authors in which he explained his thinking concerning the effects caused by the constriction of the coronary arteries including the impact on collaterals. If I find it I will post it as well.

Jon

[ed34]

http://circ.ahajournals.org/cgi/content/abstract/51/6/1053

I believe this is the one?

[kenkeith]

Jon, do you have a link to the article you are refering to.... "Although neither large coronary artery constriction nor generalized coronary arteriole constriction seem to be involved, some other specific effect of cold air inhalation on coronary vasomotion, perhaps affecting collaterals or coronary blood flow distribution, is suspected."  Its a very small sampling to come to any conclusion, and I don't find any supporting documentation.  Thanks

[kenkeith]

Good to hear personal experience verifies...open air wouldn't contain less oxygen at normal elevations, if you smoke that may be problem.  High or very high elevations may cause a respiratory problem as well.

There is another component is as extreme hot or cold conditions stress the entire body. In an effort to maintain a constant body temperature (98.6 degrees Fahrenheit), you expend additional energy to warm or cool your body. This additional energy requirement also increases the amount of oxygen your body is using.  And with a weak heart, this can be a life risk.  This is what I had in mind with my orginal post...cold weather, heavy work, big meal...bingo.

[Rosemary349]

To the original poster....

I'm hoping this wasn't a heart attack.  I guess by now you've sought medical treatment/advice?

If it wasn't a heart attack the only other thing i'm wondering is if you were having a severe allergic reaction?  You mentioned having a similar reaction when eating that food before....

Please let us know how you are!

all the best  :-)

[ed34]

That makes perfect sense to me and fits in with my personal experiences. When my LAD was very narrow and fed only by collaterals, even one breath of cold air caused bad
chest pains and throat discomfort. Now my LAD is fully open, I love going out in the cold air and breathing it ( I suppose I missed it). The air is actually very refreshing and makes me feel better rather than worse. I had always assumed cold air contained less Oxygen levels or something. Thanks for that.

[kenkeith]

From the AAC 2009

"Acute risk factors are activities and events that suddenly and transiently increase the risk of acute cardiac events, as reported recently in International Journal of Cardiology. It has already been reported that sudden submersion in cold water may provoke myocardial infarction in both subjects with atherosclerotic coronary disease and young people with angiographically normal coronary arteries.

We report a case of an acute myocardial infarction triggered by sudden exposure to cold air temperature extreme in a young person with acutely occluded proximal part of the left anterior descending coronary artery and normal other coronary arteries who had extreme obesity and cigarette smoking as cardiovascular risk factors.

Our report indicates that the sudden cold exposure and the resulting cold shock response may provoke acute myocardial infarction in young susceptible patients".

[erijon]

Can't tell you what does cause it, but based on an article I recently read it's not caused by vaso-constriction or an increase in oxygen demand as I always expected. See below;

"Inhalation of cold air (-20 degrees C) for four minutes provoked angina pectoris in four of 17 coronary disease patients at rest and in four of seven of the patients while they were paced at a heart rate level which was subanginal at room temperature. The cold air did not increase myocardial O2 consumption significantly, and the accompanying changes in systemic hemodynamic factors known to influence myocardial O2 consumption were minor. Coronary blood flow determined by the xenon clearance method did not change significantly. In 18 patients, cold air inhalation for 1 1/2 minutes caused no detectable constriction of coronary arteries visualized arteriographically. We conclude that angina pectoris induced by breathing cold air cannot be explained satisfactorily by a concurrent increase in myocardial work and O2 consumption. Although neither large coronary artery constriction nor generalized coronary arteriole constriction seem to be involved, some other specific effect of cold air inhalation on coronary vasomotion, perhaps affecting collaterals or coronary blood flow distribution, is suspected."

What I found to be interesting is that the authors of this article suspect it has to do with the cold air's effect on collaterals that may be supplying blood to the heart muscle. The authors state that areas of the heart being supplied by collaterals are affected more because even a small amount of constriction to collaterals cause a significant short term drop in blood flow causing the angina. It was believed that even the large arteries showed a very small amount of constriction, but not enough to cause a drop in O2, but given the collaterals significantly smaller size, any constriction  will reduce blood flow.

All I have saved is the above quote for a post I responded to some time back. If I can find the article I will send a link.

Jon

[ed34]

As a matter of interest, do you know why cold air affects the heart?
I'm not talking about someone feeling freezing cold, I used to just open the front door, take a breath of cold air and the angina was incredible.

[kenkeith]

It is extremely risky to shovel snow in cold weather and have just eaten a heavy meal.  All of these circumstances take blood/oxygen and may deprive the heart of an adequate supply and a subsequent heart attack.  Just shoveling snow in cold weather can be enough for some people to have an MI....happens every winter to someone.  The system stes a  priority for available blood supply.  The heart and brain is foremost, and it wouldn't be unusual to have only indigestion for the lack of good blood supply to the digestive system.

[ed34]

Well, this could take a bit of explaining, so bare with me.
When we digest food, the digestion tract and stomach need more blood supply and of course the good old heart is expected to provide this. So, if you have a heart problem, and eat something, the heart can be overloaded if the heart tissue itself isnt receiving enough oxygen. This is why so many heart problems are misdiagnosed as stomach disorders. With your jaw ache and ear problems (probably from blood pressure) it does sound rather worrying. Now, before you really start to panic, we need to put all of this into perspective.
If you exercise, say go for a walk, do you get chest pains? jaw ache? throat discomfort? shortness of breath? if so, then you are likely having signs of angina which means the heart isnt getting enough oxygen to do its work. If you do experience any of those discomforts and stand still, do they disappear within a couple of minutes? if so, this is reinforcing angina as the problem. Stomach pains dont go within a couple of minutes whereas angina does when you relax. A heart attack happens when the heart cant get enough oxygen even when you rest.
I had my heart attacks everytime I ate something which was diagnosed at first as a stomach disorder. The attacks lasted for 15-20 minutes each time. The pain was really agonising and made me sweat heavily and gasp for air. Now, I ALSO had a lot of other discomforts without eating anything, when exercising. Throat discomfort, chest pains and shortness of breath. All those symptoms would be much worse in cold air. It was assumed I had reflux. So, please understand, eating alone shouldnt cause heart attack, you would need to have other obvious signs too.
I hope this helps