Barbara Twiggs.

by Sue Ann Rybak

Barbara Twiggs, of Mt. Airy, thought she just had a bad case of acid reflux and was tired. For eight nights she slept upright in a lounge chair. Twiggs, who worked in medical billing at the time, hated to go to the doctor.

One of her pet peeves was people who used the emergency room as their doctor’s office. Twiggs said she hated to go to the emergency room and was raised with the idea that you didn’t go to the doctor unless you were really sick.

“My friends were telling me I should go to the doctor and get it checked out,” Twiggs said.

She figured she would get around to it when she had time.

“I remember thinking, ‘Lord if I really need to go to the hospital about this let me know,’” Twiggs said.

And God did just that while she was washing dishes and talking to a friend on the phone on Sunday, Dec. 1, 2012.

“It felt like a herd of 20 elephants all walked up and decided they were going to sit on my chest,” Twiggs said. “It was this unbearable pressure. I asked for a sign and I got one. I finished washing the dishes, took a shower, ironed my clothes, got dressed and went to the ER.”

She said they gave her an EKG and everything came back normal. Dr. Ray Rodriguez, a cardiologist, examined her. Rodriguez, who lives in Wyncote and has a practice in Chestnut Hill, said although her tests came back normal, he wanted to admit her.

Twiggs said he wanted to rule out everything concerning the heart.

“What was really amazing about it was all my tests were coming back normal,” Twiggs said. “Dr. Rodriguez said while nothing was jumping out at him he just didn’t feel comfortable sending me home.”

Rodriguez decided to give her a stress test. She said prior to the stress test, they had to take an ultrasound.

“I was crying profusely when they gave me the ultrasound because every time I laid down there was this tremendous pressure,” Twiggs said.

She added that the technicians called the doctor because they were nervous about giving her the stress test.

“We can’t do anything until this test is completed,” Rodriguez said.

“I remember the tech pushing my back to keep me on a certain level on the treadmill,” Twiggs said. “I was crying so bad I couldn’t talk. It was awful.”

She said the doctor said he couldn’t find anything really wrong but he wanted to do an angiogram just to be safe.

Twiggs was transported to Penn Presbyterian Medical Center. Later, the test results showed that she had a blocked artery in two places in her heart.

“After the procedure, I followed up with Dr. Rodriguez and that’s when I found out I had a heart attack,” Twiggs said.

Twiggs had a 60 percent blockage in one area and a 90 percent blockage in another area. She said if it wasn’t for Dr. Rodriguez and the quality of care she received at Chestnut Hill Hospital and Penn Presbyterian Medical Center she might be dead.

“It [Chestnut Hill Hospital] may be a local community hospital; however. behind those doors house some of the brightest doctors in their field,” Twiggs said. “We are fortunate to be so close to such knowledge and expertise.”

The heart truth

Thanks to Hollywood, the typical image of someone having a heart attack is a middle-aged man clutching his chest. In the past, heart disease was considered “a man’s disease.” But the “heart truth” is that one in four women dies from heart disease.

Coronary heart disease is a common term for the buildup of plaque in the heart’s arteries that could lead to heart attack.

Rodriguez said about 50 percent of women having a heart attack will have the same symptoms as men. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren’t sure what’s wrong and wait too long before getting help. Here are some signs that can mean a heart attack is happening:

• Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

• Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.

• Shortness of breath with or without chest discomfort.

• Other signs may include breaking out in a cold sweat, nausea or lightheadedness.

“Symptoms of a heart attack in women are different than what has initially been taught,” Rodriguez said. “More than half of women having a heart attack present with a shortness of breath and extreme fatigue. Many women don’t even say it’s a pain – just a funny feeling or discomfort in the chest. The symptoms of a heart attack are not always obvious.”

Rodriguez noted that, thanks to an increase in public awareness of heart disease and prevention programs, there has been a one-third reduction in the number of heart attacks over the last 20 years. He added that, unfortunately, women who are admitted to the hospital with a heart attack have a higher chance of dying than their male counterpart. The reason he said is that women tend to have a heart attack at an older age than men and women usually wait longer before seeking medical treatment.

Be proactive

“Heart disease can start as early as in the teens,” Rodriguez said. “It’s a gradual buildup of plaque over years and years. It’s not until it gets really bad that you start to have symptoms. You need a blockage of at least 50 percent before you start to feel anything. Which means there are lots of us walking around with 30 to 40 percent blockages.”

Rodriguez said the problem is people wait till they have symptoms of a heart attack before they begin to think seriously about heart disease.

“The analogy I give to my patients is – if you have a smoke detector in your house and you’re waiting for the smoke detector to go off to tell you there is a fire, and if your smoke detector is not that good, half the house can be burning down before it goes off,” Rodriguez said. “So, the kicker is to do the inspection of the house beforehand and look for signs of potential problems before the smoke detector goes off – because then it’s already too late.”

Rodriguez said the good news is you can slow down the progress of heart disease. He said the American Heart Association has a campaign called Know Your Numbers.

“Basically, it’s trying to educate patients to know four things: blood sugar, blood pressure, blood cholesterol and body weight,” Rodriguez said. “Knowing your numbers and not smoking are the two biggest things people can do to try and minimize their chances of developing a heart problem.

“There is a fountain of youth and it’s becoming fit,” Rodriguez said.

He said studies have shown that people who did aerobic exercise for 10 to 20 minutes a day could add 7 years to their life. Rodriguez added that most adults should get about 30 minutes of exercise five days a week.

“Unfortunately, only about 5 percent of adults are able to reach those guidelines,” Rodriguez said.

He said many of his patients don’t know how to get into shape.

“The biggest error people make is that they start out too vigorously and hurt themselves,” he said.

Rodriguez, an avid runner, hopes to run a fitness and exercise program this spring with Jackie Yorko, director at the Center on the Hill.

He said research has shown there are many benefits to exercise.

“Things as simple as walking can help lower blood pressure, lower cholesterol, delay the onset of dementia, and one of the benefits of exercise for women is that it helps minimize the onset of osteoporosis.

“When you think about it, exercise does everything you have in a pill, and it’s free,” Rodriguez said. “So, like the Nike commercial says, just do it.”