Waking Up With Chest Pain While Female

It was 4 AM on January 1, 2001. Pain on the right side of my chest woke me up. I was also sweating like I had been running in 98-degree heat.

As a registered nurse, the back of my mind whispered, "heart attack."

I thought the pain would go away with sleep

I chose not to listen. It couldn’t be a heart attack! I was only 37 years old and had 2 sons, ages 4 and 1 and a half.

I got up, took 2 TUMS, and walked around a bit, then sat upright for a few minutes. When I laid back down, I couldn’t go to sleep because of the pain. I thought if I could just make the pain stop, I could go to sleep, and it would go away.

The pain would not go away

At that moment, I came to the sudden realization that this was emergent.

I woke my husband, an emergency room RN, and asked him to take my blood pressure. He wanted to know the reason, and I told him. He immediately wanted to take me to the hospital. I made him take my blood pressure first; my blood pressure was normal.

The pain would not go away. It was not crushing or sharp and felt very much like acid reflux.

My husband called the local ER to see who the doctor was. We then had to get a sitter for our sons. I insisted on a sponge bath because I would not go to the ER "stinky!" We were in a rural area, and everyone would know!

Treatment with nitroglycerin in the ER

On arrival at the ER, I had blood drawn for lab work, an IV, a gastrointestinal "cocktail" (for reflux), an EKG, and a chest X-ray. The doctor asked me if the pain radiated. I tried to explain that it went from the size of a plum to a salad plate, pulsing all the time. He asked if the pain was relieved by the "cocktail," and I said no.

At this point, he gave me a nitroglycerin pill under my tongue. The doctor warned me that I would get a headache. Nitroglycerin dilates your blood vessels to improve blood flow.¹

After a little while, the doctor returned and asked how my headache was. I didn’t have a headache. Then he asked about the chest pain. I burst into tears when I realized the chest pain was gone, indicating that it was indeed cardiac-related!

My EKG and troponin test results

My lab test for troponin (a protein) was elevated, which also confirmed the pain was cardiac. Troponin normally stays inside the cells of your heart muscle, so when it leaks into your blood, it can indicate heart damage — including damage as a result of a heart attack. The higher your troponin levels, the more damage you have to your heart.²

By this point, my EKG also finally started to show changes.

Experiencing gender bias in a medical setting

This is where my journey took an unbelievable turn. The ER doctor called the "big" hospital to get me transferred. He spoke directly to the on-call cardiologist team.

As I listened to my end of the conversation, I realized that I might not be transferred. The ER doctor said, "But she has a positive troponin, is an excellent historian, did not respond to the GI cocktail, and did respond to the nitroglycerin."

The ER doctor came over to me after the conversation with a shocked look on his face. The on-call team would not accept me for transfer. Per this ER doctor, the cardiologist on the phone had said, "She’s a 37-year-old woman who probably partied too hard on New Year's Eve. If she’s still hurting in 2 days, we’ll see her."

This cardiologist believed me

Fortunately, my ER doctor was not biased. He told me he would call another cardiologist at the facility. If that was not successful, he would keep me at the ER until he found a facility that would take me. He believed me.

The second cardiologist agreed to admit me immediately. When the ambulance picked me up, it was snowing. We had a 45-minute drive to the "big" hospital.

Cardiac catheterization and further treatment

My cardiac catheterization was delayed 2 days because the machine broke down. It showed that I had coronary artery spasm (also known as Prinzmetal angina, or variant angina, which causes intermittent chest pain). There was a 50 percent narrowing in a tiny twig of a branch of the circumflex (the artery that goes around the back of the heart). When the artery spasms, the twig would be blocked off.^3,4

I was started on isosorbide mononitrate to keep my blood vessels dilated and discharged home with follow-up in 2 months. I’ve had a few episodes since then, which have been managed with nitroglycerin at home.⁵

Anyone can misinterpret heart attack symptoms

The most important thing I have learned is that anyone can misinterpret their symptoms, even an RN or MD. Speak up if you see someone who is in trouble and refusing help.

Have you experienced gender bias in a medical setting when reporting cardiac symptoms? You're not alone. Share an experience with us in the comments below.