On a warm Arizona morning in October 2011 I was lounging around in bed nursing a sore face from minor outpatient sinus surgery the day before. At once I began to feel a radiating heat across my chest, I broke into a cold sweat, and I felt pain down both my arms. As men are wont to do I blew it off, assuming it was a reaction to the pain medications from the sinus surgery. When the “event” ended after about 20 minutes I went back to watching television. My wife, Leslie, immediately expressed concern, but there wasn’t much she could do with me protesting that it was no big deal and I felt fine.
As a lay there in bed, my thoughts turned to my heart. Could what I’d just experienced have been a heart attack? It didn’t seem likely given how short it lasted and honestly, I assumed a heart attack would really hurt. Besides, I didn’t think I was at risk for a heart attack and certainly not at 45 years old. Like many people, I had a family history of heart disease. My father had a heart attack and bypass surgery and his father died of a heart attack. But they were much older and both of them smoked cigarettes and ate a lot of unhealthy food — you know, red meat and dairy. I had elevated cholesterol, but I was relatively thin, I exercised and had been working out with a trainer, and I ate really well. I had given up red meat years earlier and on and off I had been a pescatarian. Following my father’s surgery, I went to see a cardiologist to see what I could do to avoid ending up like him. He told me to stay on my cholesterol medication, add a baby aspirin a day and come back and see him in five years. I did as I was told, but I never did go back because things seemed fine. My high cholesterol was a result of very high triglycerides. At one point my triglycerides had been so high (north of 500) that my physician put me on a drug designed specifically to target them, and after a while, they came down and she put me on a statin to keep things in check. I had my blood checked regularly and I thought my cholesterol was under control. Sitting there in bed that Saturday morning I can probably say my total cholesterol was well south of 200. It couldn’t have been a heart attack. Later that morning I took a shower and chewed on some antacids because my stomach was queasy (I learned later that indigestion is a common symptom of a heart attack). Saturday turned into Sunday and I relaxed at home watching football like I did on hundreds of fall afternoons. By Sunday night my face was feeling better from the sinus surgery and I was ready to get back to work on Monday.
My wife, however, was not so cavalier about the whole experience. She has much better intuition than I do, and she felt uneasy about things. She insisted that before going back to work on Monday I go see my physician — just to be safe. I relented, though I admit now that had she not insisted I most definitely would have gone straight to work the next day. So on Monday morning I called my doctor’s office and asked if I could be seen that morning. I explained to the nurse that I had some “weird” symptoms from the sinus surgery I had, and of course, she told me my doctor didn’t have any openings that morning and if I was concerned I should probably go see the sinus surgeon. I thanked her (because I didn’t feel like I needed to see the doctor anyway) and texted my wife that I couldn’t get in to see my doctor. She texted me back and said to wait at home, and a few minutes later she called to tell me that she got me a work-in and to head over to my doctor’s office. She told me she spoke to the nurse and insisted I be seen and trust me when I tell you it’s hard to say no to my wife. Me, on the other hand, will do whatever it takes to not make a fuss about anything. I won’t send food back at a restaurant unless there’s a shard of glass in it. I hate returning things at stores. And I definitely wouldn’t insist on being seen by a doctor if the receptionist said there were no appointments available. I admit my desire to keep the peace is a character flaw, but in this case, it nearly caused me to die.
A few minutes later I arrived at my doctor’s office, had my vitals checked, and was put in an examination room. Before long my family physician walked in and asked me what was going on. I told her about my sinus surgery and the symptoms from Saturday morning, and she told me she wanted to get an EKG. Her assistant hooked me up to the EKG machine, ran it for a few seconds, then left with the results.
I’d been seeing the same doctor for years, and we had become friends over that time. We were close in age, we had similar political leanings, and we got along really well. In fact, my wife and I were probably the only patients she had who had been to her home and knew about her dating life. I liked her and I trusted her. So when she walked in with a worried look on her face I knew she was about to give me bad news. “It doesn’t look good, Len,” she said. “I don’t want you to panic, but I just called 9-1-1.”
Within minutes the fire department arrived at the office and started asking me questions. I told them I felt fine, but the wheels were already in motion. I was made to chew some baby aspirin and they started an I.V. drip. It was then, for the first time in two days, that I started to worry. In fact, I think I had a full-on panic attack, and it must have been obvious to them because they told me to relax and lay back. My doctor asked me if I wanted her to call my wife, so I dialed her number and handed her the phone. I could hear her telling my wife that I was getting a ride to the hospital and to meet the ambulance there. She handed me back my cell phone and I thanked her as I was being wheeled out of the office. This was going to be my first ride in an ambulance, and while I started to calm down I still didn’t think I’d had a heart attack. As we rode to the hospital, there were no sirens blaring and we stopped at red lights. I figured it couldn’t be that bad if we weren’t racing to the ER.
I’m not sure how she did it because she was at work when she got the call and she was about 20 miles away from the hospital, but my wife beat the ambulance to the hospital. As I got rolled in there she was, along with my father-in-law who had met us there. They stuck me in a curtained off area and began hooking me up to equipment. It’s funny what you think about in times like that, but for whatever reason, I was thinking about cars. I had been driving a Honda Accord at the time, another in a long line of family sedans, and I’d always dreamed of one day owning a convertible. I figured it would be a gift to myself when I turned 50, but that was still five years away. As the medical team worked on me, I turned to my wife and said, “If I had a heart attack I’m getting the damn convertible.”
What I remember next is that a tech was performing an ultrasound on my heart. As she slid the probe across my chest, she casually turned the monitor away from us so we couldn’t see the screen. It was at that point my wife said later that she knew I’d had a heart attack. For me, it was a few minutes later when a doctor walked into the room and said, “Mr. Gutman, you’ve had a heart attack and we’re taking you to the cath lab.” That’s the last thing I really member. The next thing I knew I was in a recovery room and my wife was explaining to me exactly what the hell happened to me.
What do you think about when you hear someone had a heart attack? If you’re like most people, you imagine that Fred Sanford I’m Comin’ to meet you, Elizabeth moment. The clutching of the chest. The pain. The collapse. I’d had none of those dramatic signs, yet I’d had a major heart attack. My left anterior descending artery had been about 90 percent blocked. At some point, probably during the 20 minutes or so I experienced my symptoms on that Saturday morning, a piece of plaque in that artery, commonly called the LAD, broke off and caused the blood to stop flowing to the far reaches of my heart. When blood stops feeding part of the heart, the muscle in that area dies. That damage, at least until science finds a way to bring it back to life, is permanent. It’s one of the reasons doctors say “time is muscle” when they refer to heart damage. The longer you go without blood flow the more muscle dies. Because I had waited two days to seek treatment, a large portion of my heart muscle (in an area called the apex) had stopped beating and it would never recover. The doctors estimated that I lost the use of about 15 percent of my heart. My LAD had a somewhat long blockage, one that required the placement of three stents to prop it open. Blood had pooled at the bottom of my heart, and the danger was that this clot could eventually get loose and affect another part of my body. On the bright side, the rest of my coronary arteries were clear. I was put on a blood thinner to keep the clot from getting bigger, so I was going to be in the hospital a few days while they monitored it. I was 45 years old and I had survived what they call the widow maker heart attack, a colloquial term used because more than 50 percent of people who have a widow maker do not survive. In fact, 50 percent of people who have the kind of heart attack I did do not make it to the hospital alive. I sat around the house watching football for two days after I had mine.
I didn’t know anything about heart attacks, but in the days that followed, I learned more than I ever wanted to. My heart attack was caused by plaque, some of which likely dislodged and caused a blockage. Narrowing of the arteries from plaque or hardening is called atherosclerosis, and this is the most common cause of a heart attack. But heart attacks can be caused by other things as well, such as a spasm that stops the flow of blood, or a tear in a heart artery (known as a spontaneous coronary artery dissection). Heart attacks can occur from stress or congenital issues (birth defects if you will). The heart can get damaged by a virus. Or your heart can simply just stop ticking for a variety of reasons (what the medical community calls sudden cardiac arrest). The media often use these terms interchangeably when reporting on a celebrity death, but heart attacks and sudden cardiac arrest are in fact quite different. And while not all heart attacks are deadly, cardiovascular disease (CVD) is the number one cause of death worldwide. By quite a large margin actually. According to the World Health Organization, more people die annually from CVDs than from any other cause. An estimated 17.7 million people died from CVDs in 2015, representing 31% of all global deaths. Chronic obstructive pulmonary disease (COPD) claimed 3.2 million lives that same year, while lung cancer (along with trachea and bronchus cancers) caused 1.7 million deaths. Diabetes killed 1.6 million people in 2015.
Statistics from the American Heart Association report that cardiovascular disease accounted for nearly 801,000 deaths in the U.S. in 2016 (that’s about 1 of every 3 deaths in the U.S.). About 2,200 Americans die of cardiovascular disease each day, an average of 1 death every 40 seconds. Cardiovascular diseases claim more lives each year than all forms of cancer and chronic lower respiratory disease combined. And bad news ladies — heart disease is not a male disease despite common misconceptions. Heart disease is the No. 1 killer of women, causing 1 in 3 deaths each year. That’s approximately one woman every minute. Heart disease kills more women each year than every type of cancer combined, including breast cancer.
I got lucky. But I’m not one to rest on my laurels. So instead, I decided to use my experience to spread the word about heart disease and perhaps help others who have experienced heart disease. That’s what this website is all about. I hope you’ll come back often, or even better sign up to receive an email when new posts come out. I also hope you’ll share these posts with others. It’s time we take control of our health. If I’ve learned anything from this experience it’s that you have to be your own best advocate.