Your health
Heart attacks: symptoms, risk factors, returning to work

By John McElligott, M.D.

How many of you remember comedian Redd Foxx in his role as the elderly junkman and father in the old TV series Sanford and Son? Thousands of viewers learned to recognize the symptoms of a heart attack watching Fred Sanford fake all those attacks (“This is the big one!”) on the set of his show. For the most part, those massively scary medical catastrophes don’t come out of nowhere.

There are different types of “heart attack” and even silent heart attacks that come with no symptoms. It’s important to understand what puts you at risk.

Here are some questions from truck drivers who would do well to know not only the symptoms but also what causes heart attacks. Then get to work eliminating those risk factors. You have more control over your health than you think.

Most people think heart attacks hit you like a bolt of lightning with no warning. I know this is not necessarily true. So what kinds of clues does your body give you?

One warning sign is fatigue that is not relieved by rest. Pay attention to this one, drivers. Others more obvious are shortness of breath with exertion, chest pressure with exertion, pain that radiates to the jaw and left upper arm and sweating. These are the most common symptoms of an acute myocardial infarction, or heart attack. In most cases, the event is the culmination of a long history of risk factors. Smoking, obesity and high blood pressure are risk factors that may have been in your medical “tea leaves” for decades prior to the acute symptoms that you say hit you like a lightning bolt.

One big risk factor overlooked by many is your family history. It’s important to know whether one or both of your parents suffered a cardiac event, how old they were and other information. This is often the key factor for developing heart disease and worth the investigation if you don’t know.

Why do you hear of so many truck drivers suffering a heart attack on the road?

Truck drivers have one of the most stressful jobs in the world. In addition, busy schedules and being miles from home do not add up to regular medical care. Most still do not have health insurance. Irregular sleep, poor diet, lack of cardio exercise – all can contribute to a heart attack on the road. Because of decades of neglect, many truck drivers often do not survive their first attack. In addition, a hesitation to call for help in conjunction with a driver’s mobile and maybe isolated whereabouts decreases the chances of quick emergency medical response.

If you have a heart attack, can you go back to trucking? Do you lose your CDL? What do you do to get it back?

Yes, you can go back to trucking. Suffering a heart attack does not always DQ you from driving. Some drivers can return in the DOT-prescribed two months and some never. You must be cleared by a cardiologist.

The “return to work” depends on the extent of damage to the heart muscle. If severe damage occurs, chances are the driver may not be able to return. Most drivers do return if treated soon after the attack and rehab is successful. It’s critical that a driver who has had a heart attack discuss the reasons with his/her physician, identify those risk factors, and work to correct the ones that can be changed. If risk factors are not corrected, it is my experience that it’s not long before another heart attack occurs. LL

John McElligott, M.D., is a Fellow of the American College of Physicians. He is a certified medical examiner with the FMCSA’s National Registry of Certified Medical Examiners.

This column is the opinion of the writer and does not necessarily reflect the opinions of Land Line Magazine or its publisher. Everyone’s health situation is different. If you have questions regarding medical issues, consult your personal physician.