Trucker MD
What you need to know about heart attacks

By John McElligot, MD

There are many theories about having heart attacks – what the symptoms are and what happens right before you have the cardiac event – but as in many health situations it’s not a one-size-fits-all situation.

In my 40 years of treating patients I have seen most of the ways that acute coronary syndrome, known as ACS, presents itself. 

This syndrome can present the classic symptoms of chest pressure, shortness of breath and sweating, but can also present with none of these symptoms at all. So in this column, let’s stop with guessing games and ask some really critical questions that will help you assess how much you have to fret.

If you are worried about having a heart attack, you need to look at your risk factors. If those risk factors add up and the answer looks like a yes, then you need to get busy correcting those risk factors. In my experience, the leading risk factors are smoking, obesity, cholesterol and diabetes.

Dr. John’s list of leading risk factors

Can you eliminate any of these?

  • Smoking
  • Obesity
  • High cholesterol
  • Diabetes

Any of these apply to you? All of them maybe?

When it comes to truckers, the individuals who check yes to these four factors will without a doubt be headed for a cardiac event at some point. Having said this, there are many other factors that can add fuel to the fire such as age, family history and increased stress levels. The latter is a totally overlooked risk factor in trucking.

Truckers are likely to have these classic risk factors, which are exacerbated a hundred times over by dangerous, isolating situations. This profession is plagued with stories of sudden death while on the road.

One does not have to have chest pain, shortness of breath or be sweating to be having a heart attack. This is especially true in truckers who are constantly going from low altitude to high altitude and then back down quickly. We are inundated in the medical profession by truckers who will call and say I’m short of breath. When asked “where are you?” it’s no surprise to hear “I’m in Denver.”

If you think there’s always got to be the massive chest pain, you watched too much Redd Foxx as Fred Sanford when you were growing up. He was always grabbing his chest and yelling “This is the big one! I’m coming to join you, Elizabeth! You hear that, honey?”

When I get a call, if I confirm three of the big four risk factors – smoking, obesity and diabetes – I will immediately refer a truck driver in trouble to an emergency room where a great many drivers will unfortunately be diagnosed with ACS.

Often the acute coronary syndrome may be accompanied by acute blood clots in the legs that have moved to the lungs and this really causes chest discomfort. When this happens, we have what is known as a total system collapse.

And frequently pressure in the chest is overshadowed by shortness of breath, especially in diabetics. Here’s another fact to pay attention to: A great many diabetics who have ACS do not experience chest pain. So, as usual, don’t believe everything you read and make sure you look at your risk factors.

OK, here’s a challenge. Try to eliminate at least one to two of those risk factors for six months. I have seen some good reports from those who succeed in this.

Pay attention to your health for your friends and family. They will appreciate your efforts. LL

John McElligott is an MD, Fellow of the American College of Physicians, and medical director of the St. Christopher Truckers Development and Relief Fund. This column is the opinion of the writer and does not necessarily reflect the opinions of Land Line Magazine or its publisher.