The heart attack she almost ignored

On Sunday, April 12, Maria Valdes, 48, drove herself to urgent care. She figured she'd pulled a muscle while mopping the day before.

However, she was actually having a heart attack.

The first symptom came days earlier. "It felt like a brain freeze, but in your arms," Maria says.

Then the palms of her hands started to feel sunburned.

Maria, who works in San Diego's tourism industry, had no family history of heart disease, so she disregarded her symptoms. "I thought, 'Oh, it's just carpal tunnel. Or it's probably a pinched nerve,'" she says.

Maria put pain-relief patches on her wrists and went on with her weekend. Then, on Saturday, April 11, she felt dizzy. She sat down to rest and took two aspirins. The dizziness passed.

The next morning, Maria woke up feeling great. But after standing up, she started feeling sick. When the aching in her arm returned, she decided to go to urgent care.

'I’m supposed to go to Disneyland'

At urgent care, a doctor listened to her heart. Within minutes, nurses were gathering her belongings for an ambulance ride to Sharp Memorial Hospital.

Maria still had her mind on the next day’s plans. "I'll be fine tomorrow, right?" she remembers asking. "I'm supposed to go to Disneyland."

Bloodwork in the emergency room confirmed a heart attack. Doctors placed a stent to open a blocked artery, and Maria spent the next several days recovering in the hospital.

Why women's symptoms can look different

As strange as Maria’s symptoms seemed, they weren’t unusual for a woman having a heart attack.

"Women present quite differently than men," says Gabrielle Antonio, a clinical exercise physiologist with cardiac rehabilitation at Sharp Memorial Hospital.

While men more often experience the classic chest pain that can radiate down the arm, Antonio says women are more likely to report shortness of breath or pain in the shoulder, back or jaw.

She encourages people to learn about their heart health risk factors in their 20s and 30s. "Some of them are within your control, and some of them are not," she says.

Age and genetics can't be changed, but cholesterol levels, blood pressure, physical activity and diet can be.

'I felt useless'

Before Maria was discharged, her care team recommended cardiac rehabilitation. What she imagined seemed intimidating.

"I envisioned myself as an astronaut, electrodes everywhere," she says. "They were just going to put me on a treadmill and say, 'OK, go.'"

Her first session was harder than expected. "I felt useless," she says.

Antonio says nearly every patient arrives feeling something similar. "You're going to look back at yourself in three months and realize where you were when you started with us, and you're going to be shocked," Antonio tells them. "That's what we see every day."

Cardiac rehab, Antonio explains, is "almost like physical therapy, but for the heart."

Exercise physiologists and nurses design a personalized aerobic and strength program while monitoring heart rate, rhythm and blood pressure. Someone walking 1.5 mph on a flat treadmill the first week may finish the program closer to 3 mph on an incline.

"It builds their confidence just as much as it builds their physical capacity," she says.

The moment it clicked

One morning, Antonio raised the incline on Maria's treadmill and kept her talking. Before she knew it, the workout was over.

"I was walking and talking," Maria says. "That's the first time I've done that in a while."

During a monthly check-in, Antonio suggested Maria start taking walks on her own at home. "Her face lit up, and she said, 'I'm allowed to do that?'" Antonio recalls.

Now, Maria arrives with progress updates. "She'll come in with the most joyful face — 'I walked for 45 minutes with my dad on Saturday,'" Antonio says of Maria’s delighted reports.

'It feels really safe'

Maria credits her care team as much as the treadmill. "They're so sweet, encouraging and attentive," Maria says. "It feels really safe and welcoming.”

Antonio says that's deliberate. "We intentionally get to know each person that comes through our door. We take interest in their lives, concerns and goals."

For Maria, that made asking for help easier, something that had never come naturally. "I don't feel embarrassed or afraid to ask for help," she says. "And that's really hard for me to do."

Some mornings, when her 5:45 am alarm goes off, she still doesn’t want to go. She goes anyway. And thanks to her care team and the effort she’s put into her rehabilitation, Maria continues to feel stronger every day.

Antonio's advice to anyone hesitant: "Just give it a few sessions,” she says. “It's not as scary as it seems. We’re going to meet you where you're at."

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