Myocardial Infarction (heart attack) or Esophageal Spasm?
by Marijo Phelps
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It started out being a really good day – we splurged at breakfast and had bacon, something we usually didn’t do. I was on my way to get my hair a bit curlier with a perm.
“Hi, Marijo, please have a seat, would you like some specialty coffee with creamer?”
“That sounds yummy, Linda, thanks…”
A bit later, what with the twists and turns and laying down backwards into the shampoo bowl I was having some gastric reflux. Not a fun thing but I had overdone it a bit on the fats that morning.
Perm was finished and I got into my truck. As I began the drive home it felt like a hand had reached into my chest and was twisting and squeezing. I also had pains radiating up my jaw. As an RN, the thought crossed my mind that I might be having a myocardial infarction (heart attack) and that I should not be going home but to the emergency room. Being a typical RN, relatively stubborn regarding our own health issues and not believing it could really happen to me, I drove home.
(I WILL GO ON RECORD HERE SAYING DO NOT TO AS I DID – PLEASE, GET EVALUATED RIGHT AWAY…)
Somewhere in this process I decided to take an antacid. Just about as soon as I swallowed and it “hit bottom” I felt relief – the pain subsided in the chest and in my jaw and teeth.
I called my MD the next day and she said it sounded like an esophageal spasm BUT didn’t want to be overlooking something cardiac and sent me for a full cardiac workup including treadmill stress EKG and the works.
Turned out my heart was fine and it was an esophageal spasm. Apparently the combo of the fats and the caffeine in the delicious coffee set things off in a grand way.
Fast forward. I am working at a fairly large office. The young man across the cubical from me is having chest pains. I am thinking this young husband and father is way too young to be having cardiac issues. He is in the middle of a complete cardiac work up. The doctors were scratching their heads so far.
You almost never saw “Mark” without a can of Mountain Dew in his hand. He loved the stuff. Morning, noon and night it was never too early for a Dew, just ask him….
“Mark, I have a challenge for you regarding your chest pains….”
“Man, I am so miserable I would try just about anything, what are you thinking?”
“Think you could stop the sodas for about two weeks? Maybe you could wean off so the headaches wouldn’t be so bad but get off and stay off for 2 weeks?”
I then told him about my experience and how every time I had anything with caffeine I could almost guarantee triggering an esophageal spasm – add some fat to the mix and sometimes even carbohydrates like bread and it was a “done deal”.
“Okkkkay, I guess I could give it a try – this pain is terrible and thinking I might be having a heart attack and not knowing what to do is even worse…. You’re on!”
By the end of his two weeks he had a super grin on his face AND no further chest pains. He checked with his MDs and told them what had happened and they confirmed that yes, this could be cause and effect.
Fast forward again.
We were building a house (what’s news about that for the builder and his wife?) and our electrician was our friend who also owned land up this way. We were trading labor and spent much time working with him on our place and his.
“Gray, what’s with the grimacing face?”
“Man, my chest hurts like someone is squeezing the life out of me….”
I ran and got him an antacid and he took it and the pain stopped…. Whew, we didn’t have to call the med-evac helicopter….and Gray said he wasn’t about to go be checked anyhow… (hum, maybe men are wired a bit like this stubborn RN?)
We began a dialogue. This guy was Mr. Coffee and we had affectionately called him that for months.
“Ah, Gray, how long have you had these chest pains?”
“Oh, for months and months but they seem to be getting much worse lately. Sometimes I’m so miserable I can’t work”
“Want to try an experiment that might fix them for good?”
“Are you kidding, what could I do…?”
I then told him my experience and Mark’s regarding caffeine and the antacid “test” I did. He looked at me like I had taken a glass of cool water away from a man dying of thirst but gave a reluctant “yah…. Guess I could try that by going slowly off the coffee…..”
I think I could really hear the sob behind his words.
We had finished out electrical part of the house for them and didn’t see him again until it was time to do the next phase. He walked into the house with a grin on his face which told the whole story.
“Hey, Doc, look at me, no more chest pain!”
“Ahhh, and how were the headaches going off coffee?”
“Oh, they were not too bad after the first couple of days and it was SO worth it! Do you know that even decaf causes reflux?”
“Well, there is something in the coffee bean, leaded or unleaded, that makes you produce more stomach acid so I guess that could be part of it all, couldn’t it?”
“Yep and for the major relief I have gotten guess I will bum a glass of your wonderful well water.”
“I’m really glad to see this little “fix” of mine work so well for you, Gray. Congrats for sticking it out and getting off the java, but now we can’t call you Mr. Coffee anymore.
SO NEXT TIME YOU HAVE HORRIBLE CHEST PAINS, POP AN ANTACID ON THE WAY TO THE ER. BETTER YET, BEFORE YOU GET TO THAT STAGE MAYBE TRY TO MODERATE YOUR CAFFEINE BEFORE THE MISERY STARTS.
(C) Marijo Phelps all rights reserved. Use with proper credits.
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Great information here(except for taking a big chance, you had to have the exam anyway,and if it was a heart attack, all of that would have been too late!)A great thought for prevention at least, then one would know enough to get to the emergency room if you were off of all the things that can cause the acid reflux.