Diane Feenstra wasn’t too terribly alarmed when she felt a little tightness in her chest this spring. Still, she decided to glance at her smartwatch — a birthday present from her husband — to check her pulse.
The reading: 169 beats per minute at rest. She hadn’t exercised or been active at all.
“I thought maybe there's something going on health-wise that I should check out, but I still didn't think I'd had a heart attack or that probably I was heading toward another one that day,” Feenstra, 69, who lives in Norton Shores, Michigan, told TODAY.
She texted her husband for advice, who told her to call her doctor immediately. She headed to the nearest urgent care, where a physician looked at her EKG, handed her four baby aspirins and told her chew them right away.
Next stop: a cardiology center in Grand Rapids, where tests showed evidence of a recent heart attack and blockage of the left anterior descending artery, the largest coronary artery that supplies blood to the front of the heart. An obstruction there can cause a “widowmaker” heart attack — called that because it can cause a lot of damage. Another EKG looked “messy ugly,” Feenstra was told, with the cardiologist preparing her for the possibility of heart failure.
But a cardiac MRI showed her heart was viable and doctors inserted a stent to open the blockage.
Feenstra credited her Apple Watch for potentially saving her life on that day in April.
“Were it not for the fact that I had that 169 beats per minute for a period of time, I wouldn't probably be here today,” she said. “Seeing it on my watch told me you have something going that you need to investigate now.”
In hindsight, Feenstra had heart attack symptoms she had dismissed or explained away to other causes. Like many women, she expected a heart attack to produce “elephant sitting on your chest” pressure, when the signs can be more subtle.
Beginning in February, she felt intense pain that started in her neck and ran down to the wrist of her left arm, but it would come and go so she figured it was arthritis.
When she later experienced pain in her neck and back, she assumed she had vacuumed too aggressively. When she felt fatigued, she blamed it on winter and being stuck inside without regular exercise.
There was one night in particular when Feenstra couldn’t sleep and felt so nauseous that she put a wastebasket by her side just in case she had to throw up, but she figured it was just something she ate.
“I didn't think it was a heart attack at all, and I should have,” she said, noting that her oldest sister died of the condition. “I really should have been more attentive to my health.”
When it comes to heart attack symptoms, women have more shortness of breath or nausea and vomiting than men. Women also more frequently have pain in the neck, jaw, throat, abdomen or back.
Heart disease is the No. 1 killer of men and women in the U.S, so it’s important to pay attention to the symptoms, said Dr. Andrew Freeman, a cardiologist at National Jewish Health in Denver, Colorado.
But he cautioned that just because a person experiences a fast heart rate, it doesn’t necessarily mean an imminent heart attack or require a trip to the emergency room. A speedy pulse at rest is a response to a stressor and can be caused by watching a scary movie, receiving bad news, preparing to give a presentation or battling an infection like a cold.
“Your heart is sort of the fastest way your body can respond to increased demand,” said Freeman, who is not treating Feenstra, but commented in general.
“When you're having a heart attack and part of your heart may not be functioning so well, the quickest way your body responds is to increase heart rate, so heart attack could certainly be on the differential, but it probably wouldn't be the most common way people would present.”
He called smartwatches a “double-edged sword” because they can collect important health data, but also lead to information overload for patients and their doctors. The ultimate goal is to have the data filtered in a way that physicians can look at the things that matter, when they matter, as opposed to every single heartbeat, Freeman said.
Still, “if you do notice that your vital signs are ever out of whack… it's good to get them checked out,” he added.
For most of adults, a resting heart rate of 60 to 100 beats per minute is normal, according to the American Heart Association.
If your smartwatch shows an unusually high pulse, double check and measure it yourself by putting your fingers under your neck or on your wrist, Freeman said. If the number is accurate, look for an explanation or any accompanying symptoms. A very rapid heart rate at rest that’s accompanied by chest pain, palpitations, shortness of breath, lightheadedness or a faint feeling should prompt an emergency visit.
Meanwhile, Feenstra is “feeling wonderful” and going to heart exercise class for an hour three times a week. She urged other women to pay attention to subtle symptoms.
“Listen to your body. It's trying to talk to you,” she said.