Morris is a man in his 60s who is like an uncle to me. I've never seen him smoke, drink to excess or complain about anything except the economy. When Morris recently developed right shoulder pain when doing physical work, he kept pushing on and took an occasional aspirin. One night after a day of moving some heavy items at his furniture store, Morris confessed to his wife that he had pain in his right shoulder. "The Boss," as Morris fondly calls her, made an appointment with an orthopedic surgeon and after X-rays, an MRI, a steroid injection and some physical therapy, Morris's right shoulder pain improved. But he still took a doctor-ordered break from all the stress of running his business.

One month passed, and Morris returned to work. But within minutes, he became suddenly, profoundly weak and collapsed. Someone called 911, and a quick check by an excellent paramedic found that Morris was experiencing a dangerously slow heart rate. In the hospital, Morris received a permanent pacemaker and is now doing fine. Interestingly, the chest X-ray that was done to confirm the placement of his pacemaker gave us a good view of both of Morris's shoulders. In retrospect, his right shoulder pain was probably due to "referred" pain from his heart. The occasional aspirin he took for pain relief probably helped prevent blood clots in Morris's coronaries (for a while, at least). He now takes aspirin daily.

You don't have to have chest pain for your heart to be in trouble. Research shows that 8% of patients diagnosed with acute coronary syndrome (marked by sudden discomfort or pain or shortness of breath due to coronary artery disease) have so-called atypical presentationswith no chest pain. These patients are three times more likely to die in the hospital—perhaps because their true condition is so likely to go undiagnosed.

To protect yourself, see your doctor if any level of exertion leads to…

  • Aching pain in either shoulder or arm.
  • Unexplained shortness of breath.
  • Unexplained weakness or sweating.
  • Heart palpitations.

Call 911 if any of these symptoms are acute or seem severe.

Whatever you do, don't just try to push through the discomfort. You might not be as lucky as Morris.

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