Chest and arm pain, fatigue

After Chris Prewitt finished lifting weights during a session with a personal trainer on December 27, 2023, he felt unexpected pain. Although it was his first time working with this trainer, Prewitt, then 48, worked out frequently, including cardio and CrossFit.

“It wasn’t a particularly hard workout,” the 49-year-old from Avon Lake, Ohio, told TODAY.com. “But afterward, my triceps, biceps and chest were incredibly sore.”

Concerned, Prewitt’s trainer called a sports medicine doctor, who advised Prewitt to go to the emergency room. His wife, Meredith, packed the kids into the car and rushed to pick him up. She missed the exit to the emergency room, but realized they were right next to a hospital. She took one look at her husband, who was gray and hypothermic, and rushed him to the emergency room. This was a stroke of luck, because Prewitt was having a heart attack.

“I had a single artery that was completely blocked,” he says. “It’s the left anterior descending artery… the so-called widowmaker’s artery.”

“Image of Health”

Over the years, Prewitt has exercised extensively, running hundreds of 5Ks, completing two marathons, and participating in CrossFit. He doesn’t drink, doesn’t do drugs, eats healthy, and prioritizes sleep.

“I’m often seen as the paragon of health,” he says. “I do everything you’re supposed to do.”

In the year before the heart attack, Prewitt felt mostly fine, but noticed he tired easily. He attributed this to his age and parenthood.

“I didn’t know if this was what it would feel like to be almost 50,” says Prewitt. “I have two young boys, ages 9 and 6, and I was a little tired at the end of my workday and sometimes needed a break before we went to play baseball or play soccer in the yard.”

Just to be sure, he went to the doctor three times and had blood tests done, the last one a month before his heart attack.

“I didn’t have any markers. My total cholesterol seemed fine,” he says. “Other than the fatigue, I didn’t have any real health problems.”

For Christmas, his wife gave him a five-pack of training sessions with a trainer, and Prewitt immediately scheduled his first session. After the session, he described the sensation he was feeling in his arms and chest to the trainer. The trainer was concerned and sought medical attention. The doctor recommended that Prewitt go to the emergency room to have his heart checked.

“I call my wife to come pick me up, which is a miracle in itself. I’m pretty stubborn,” he says. “I’m not the type to take advice.”

They got lost on the way to the clinic.

“She missed the emergency room exit and got off the highway, and I was slumped in my seat,” Prewitt explains. “She had never seen anyone with gray hair like that before, and she grabbed my hand. She was ice cold. My heart had stopped.”

Across the street, however, Meredith saw the Cleveland Clinic’s Avon Hospital on the Richard E. Jacobs campus.

“She ran three red lights, drove to the emergency room and ran in,” he says. “A couple of nurses came, got me out of the car and brought me back to work on myself.”

For twenty minutes, Prewitt received CPR and a dozen defibrillator shocks while staff tried to get his heart rate back up. After they stabilized him, they sent him to another Cleveland Clinic facility that had a cardiac catheterization lab. Tests showed Prewitt had suffered a “widowmaker” heart attack.

“I was able to be brought back,” says Prewitt, adding that he regained consciousness about 24 hours later.

Heart attack caused by widowmaker

When the left anterior artery is blocked, a condition known as a widowmaker heart attack can occur. Younger patients like Prewitt may not experience any symptoms.

“About 30% of patients have no prior symptoms but suddenly drop dead,” Dr. Emad Nukta, a cardiologist at the Cleveland Clinic, tells TODAY.com. “We see this more in younger patients than in older patients, and that’s where the term widowmaker comes from.”

Sometimes patients have subtle symptoms, such as fatigue, that they do not consider to be signs that something is wrong.

“The worst thing is when those affected show no symptoms at all. They didn’t notice anything,” says Nukta. “They were exercising, lifting weights or on the treadmill, and suddenly they dropped dead.”

Symptoms may include:

• A feeling like indigestion
• Arm or neck pain
• Chest pain

Nukta says a heart attack is often accompanied by extreme pain, but that is not always the case.

“That’s a big misconception. They think pain is something like a real burning sensation or a strong pain,” he says. “But chest pain is actually not that strong of a pain. It’s an uncomfortable pressure pain, a pressing pain.”

People with a lifestyle that increases the risk of hardening of the arteries (atherosclerosis) have a higher risk of getting widowmaker, says Nukta. Risk factors include:

• Being a smoker
• High blood pressure
• High cholesterol
• Heart attacks in the family
• Have diabetes

He says it’s important for patients to know their family history to know if they’re at risk of widowmaker disease. After a heart attack, most patients still need to see a cardiologist.

“I tell my patients that if they have a heart condition, they are tied to me,” he says. “They will always be a heart patient.”

“A very blessed life”

Although Prewitt knew that one of his grandfathers had two bypass surgeries, he was unaware that his other grandfather had died of a heart attack at age 49, which was a death sentence.

“My lesson to all the people I’ve told this to is that you may think you’re doing everything right, but if you don’t know your genetic history, you need to find out and tell your GP as well,” he says.

Prewitt now takes several medications to support his heart and keep his artery open. He recently completed cardiac rehabilitation.

“After 12 weeks, I was running a good nine-minute mile,” he says. “I have no limitations. A month ago, I went to Universal Studios with my wife and boys and rode a roller coaster. I’m still running and lifting weights.”

Through this experience, Prewitt has learned the importance of healthy habits and encourages others to “take their health very seriously.”

“There are health markers or genetic things that are encoded in you that you can’t escape,” he says. “Through knowledge and proactive medical care, you can detect these things early enough and do something about them before it becomes a real event.”

A heart attack caused Prewitt to rethink his life.

“It’s incredibly painful to think that my little boys have to go through life without their father,” he says. “For most of my life, I was terrified of dying. Have I done enough? Have I lived enough, lived the life I want to live? And after this event, I’m no longer afraid of dying. … I’ve lived a very blessed life.”