Bishop T.D. Jakes, head of the Potter's House megachurch in North Texas, recently went public about his medical emergency while delivering a sermon in November.
Jakes told NBC he felt no symptoms like chest pain or numbness, so he had no idea a heart attack occurred until doctors told him later.
KERA’s Sam Baker spoke about this with Dr. Carl Horton, a cardiologist with Texas Health Cleburne and Texas Health Physicians Group.
Dr. Horton: If you watch the video he kind of became incoherent. Even though he may not have physically felt it himself, he did have symptoms.
In the interview that I saw the artery that was affected was the right coronary artery which is on the back side of the heart and sometimes that kind of determines what symptoms that people will have.
You know, sometimes people can have milder symptoms, particularly not with a very large heart attack. If they have a milder heart attack where they call a non-stemming, a non-ST elevation MI , then a lot of times they will have kind of more milder symptoms. But usually, within acute occlusion, meaning a larger heart attack, most patients will have symptoms.
Baker: What exactly did he have, do you think?
I think what happened was that at that time, he became incoherent during that service, you know. He may have had an arrhythmia at the time where his heart briefly went out of rhythm, went into a ventricular arrhythmia , and then, when that happens, the brain doesn't perfuse with oxygen. And so I think that's likely what happened.
So heart attacks don't present the same way each time with each person?
That is correct. And, you know, we know women don't always still have the classic symptoms, but sometimes it does depend on location.
You know, a lot of times, like I described that backside artery patients can have more symptoms of, you know, more severe nausea or vomiting, or we have a saying in cardiology that, you know, that indigestion, sometimes you just have indigestion and that we say that indigestion can kill you.
But rarely can patients have kind of a sinkable event where they just have jaw or neck pain.
Now, if it's the widowmaker, the LED, or one of the arteries on the side of the heart, the left circumflex artery or left main, then usually patients will have severe symptoms.
A lot of times they have more of the classic type of “Fred Sanford, Elizabeth, I'm having the big one” severe crushing chest pain, but not all patients present that pain.
Aren't there maybe signs that occur earlier that such a thing could happen or maybe is coming?
I would say sometimes patients will think back after the event occurs, “oh, you know, two weeks ago, I kind of did have this weird sensation that happened when I was, you know, jogging or raking leaves or whatever.”
So, some patients actually will have some minor signs beforehand, and they, you know, they kind of notice it, but then they kind of ignore it and go about because it doesn't last or persist.
But then some patients truly do have no symptoms before an acute event, and it happens out of the blue. And we don't necessarily know what always triggers that, but usually when that happens, they have acute plaque rupture. So, the cholesterol plaque in the artery completely occludes, and then they have a major event.
So, when you get a little sign like the type you mentioned, should you go straight to the doctor at that point?
I would say usually if you're having any symptoms that's not normal for you, it's always good to get checked out, you know. And even if your tests are negative, doesn't show any signs that you had an acute event, you can kind of put your mind at ease that you have been evaluated.
I think what happens is a lot of patients, you know, they don't get evaluated or you're kind of at risk for atherosclerosis, depends on a lot different things: Your risk profile. Are you diabetic, hypertensive? What's your family history? Are you a current smoker. So, you have to look at all those things in terms of what your risk would be. It never hurts to get evaluated.
What symptoms should you look for or keep an eye out for?
Definitely any severe chest pressure or tightness in the chest. A lot of times patients will say, well, I don't have chest pain. But if you have pressure or tightness or heaviness, that always usually needs to be evaluated. And particularly if you're having that with any exertional or physical activity.
Also, some patients will have just more shortness of breath or what we call dyspnea. If they experience any more exertional dyspnea where they can't really function and do the activities that are normal for them, then they definitely need to get evaluated as soon as possible.
Steps of prevention that you should take against this kind of thing happening. I'm assuming we're talking about lifestyle changes.
You want to have a healthy diet with a lot of more fruits, salads, nuts, vegetables. Lean meat, if you're going to eat meat.
And then regular physical activity. Usually, I tell patients 40 minutes four times a week that they need to try to do something physical.
Who's at risk for a heart attack or an event such as Bishop Jake went through?
Heart disease is the number one killer, you know, nationally, and I think worldwide also. So, everybody potentially is at risk, depending on your age and what your risk factors are.
Traditionally, men tend to develop atherosclerosis at an earlier age than women, but even in women, especially once they go through menopause, their risk begins to increase as they get older.
RESOURCES:
CDC: About Heart Attack Symptoms, Risk, and Recovery
