At the right place, right time — for a heart attack


Being aware of key symptoms and signs of a heart attack and getting prompt medical care save a life. Symptoms can occur suddenly or slowly over a period of time. Usual signs of a heart attack include chest pain (an uncomfortable pressure, squeezing, fullness or pain in the center or left side of the chest that can be mild or strong). It can last for a few minutes or keep going and coming back. Other signs include discomfort in one or both arms, shortness of breath and nausea. Women more often experience atypical symptoms, such as jaw pain, headaches and fatigue.

With soaring medical prices and long waits, most people will do whatever they can to avoid a trip to the ER. Below are 10 medical conditions that should prompt you to go to the ER based on a summary by Emory University Hospital of the American College of Emergency Physicians’ list.

1. Difficulty breathing, shortness of breath: This could be a sign of an asthma attack or even a heart attack. Any difficulty with breathing or shortness of breath should always be taken seriously and checked out by a medical professional. Women often experience shortness of breath when having a heart attack, but ignore the symptom.

2. Chest or upper abdominal pain or pressure: If you feel discomfort or pain like a tight ache, pressure or squeezing in your chest lasting more than a few minutes, it could be a warning that you are having a heart attack. This pain may extend downward into your abdominal area and could feel like heartburn.

3. Fainting, sudden dizziness, weakness, lack of mobility.

4. Changes in vision: Sometimes stroke victims experience double vision or loss of all or part of their vision.

5. Confusion or changes in mental status: This includes difficulty speaking, unusual fatigue, and feeling disoriented. These could be signs of a stroke, seizure, dehydration or another major problem.

6. Any sudden or severe pain: A severe headache (the worst you have ever had) could be signaling a brain aneurysm. Severe abdominal pain could indicate either an appendix attack or a stomach aneurysm. An acute shooting pain or heavy discomfort in the left arm could be a sign of a heart attack.

7. Uncontrolled bleeding: If you have applied pressure to a wound for 15 to 20 minutes and it does not stop bleeding, then you should see a medical professional who can assess the injury.

8. Severe or persistent vomiting or diarrhea.

9. Coughing or vomiting blood: This could mean a bleeding ulcer, tumors in the stomach or esophagus, or a serious lung disease.

10. Suicidal or homicidal feelings: Sometimes a person with a mental disorder begins exhibiting behavior that could be dangerous either to himself or others around him. It is vital for a medical professional to see the person. Be sure to tell the ER staff what medications, if any, the person is taking.

It was a Wednesday afternoon when Dr. John Muse, a local oral surgeon, started feeling sudden, sharp chest pains.

Muse usually didn’t go to the office on Wednesdays, instead catching up on paperwork at home, then playing golf. But on the Wednesday of May 14, 2014, Muse decided to spend a full day at his Decatur office, a fateful decision that likely saved his life.

Shortly after lunch, he called his nurse. Instead of needing assistance for a patient, it was Muse, reeling in pain, who required immediate help (while waiting for an ambulance to arrive).

For Muse, there was no question he was having a heart attack, and he recognized the need for immediate medical attention. Other times, however, people may face less obvious signs of a heart attack. (See accompanying box.)

The moment Muse arrived at Emory University Hospital, he turned blue and collapsed. He went into ventricular fibrillation — a heart condition where the lower chambers of the heart quiver, leaving the heart unable to pump any blood, and causing cardiac arrest.

“A miracle,” Muse says about going into cardiac arrest inside the ER surrounded by a medical team.

He was “essentially dead” and was shocked with the defibrillator about seven times, according to Dr. Jean Wheeler, a medical resident in the emergency department when Muse was brought in.

Muse, now 55, is an example of a seemingly fit man (a trim, avid runner, a healthy eater) who didn’t face the risk factors associated with heart attacks — except for one.

“Doctors said two things: one, bad luck and two, too much stress in your life,” Muse said.

Dr. Kreton Mavromatis, associate professor of medicine in the Division of Cardiology at Emory University School of Medicine, and his team stopped Muse’s heart attack and restored blood flow using catheters and tiny balloons. They then placed a stent to keep the artery open.

Afterward, Muse spent five days in Emory’s cardiac intensive care unit. At that point, the main concern was brain function, knowing that his heart stopped multiple times during his heart attack. When Muse awoke, however, it was clear his brain function had remained intact. He reached for his wife Carey’s hand. He looked around the room at all the people pulling for him to make it through.

After returning home and making a full recovery, Muse wrote a letter of gratitude to Emory University Hospital Chief Executive Officer Robert Bachman asking for the opportunity to say thank you to the teams of people who cared for him. He was recently given the chance to go back to the hospital to express his appreciation. He also spoke to an Emory University Hospital Department Directors Meeting in April, recognizing not only the medical team, but others who made a difference, including a staff member who went into his room to get the trash and said, “Hang in there. We are all pulling for you.”

“They not only saved my life,” he said, “but they were doggone nice about it.”

For Muse, the heart attack forced him to look at the stresses in his life and how he tended to overschedule himself. He scaled back the number of hours he dedicated to his profession, particularly his involvement in organizations.

Six weeks after his heart attack, he took a trip to the Grand Canyon with his daughter, Elizabeth, 19, where they hiked and rafted. A few months after that, Muse and his adult son, Chris, 25, took a motorcycle trip on the Blue Ridge Parkway.

While Muse said he always enjoyed spending time with his wife and children, his life-and-death experience a year ago deepened his understanding of just how precious life is.

“I am living more in the moment,” he said. “Life is really short. I better not blow this, and make a difference.”