Caroline Zentner
lethbridge herald
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When Joyce Harmatiuk was 42 years old she was like many women, busy juggling the demands of life and caring for her family.
Six years ago she had three teenagers at home, a full-time job as a nurse in the neonatal intensive care unit and a husband who was soon going to be away training at the RCMP Depot Division.
"We knew he was going to be going away and he was going to be gone for six months to Regina," Harmatiuk said. "I'd begun dreading it but I started to have physical symptoms about that time, just probably two weeks before he left was my first bout of angina."
She had all the typical male symptoms of angina, including crushing chest pain and sweating.
"I really just didn't know where to put myself or what had brought it on; I laid down for a couple of minutes and then it passed," she said. "So I thought 'I can't be suffering from heart disease; that's just not possible.' So I picked myself up, got ready and went to Costco because that's what you do when you're in denial."
With February being heart month, Harmatiuk's experience is right in line with the messages of the Heart and Stroke Foundation's The Heart Truth Campaign highlighting women's heart health. This year's Red Dress Gala, set for Valentine's Day, aims to raise money for the Heart and Stroke Foundation and the Chinook Regional Hospital Foundation's heart health centre.
After that first episode of angina, Harmatiuk felt it again the next day as she was sitting on the couch having a cup of tea. She couldn't find an explanation other than having a hot beverage.
"I started to try to come up with some sort of diagnosis for this," she said. "I came up with a diagnosis of esophageal reflux. It's a condition where if you're having reflux you're going to get chest pain with it and it passes and this is what was happening with mine."
The stress in her life increased with her husband Brian off to training, contributing to an overall feeling of being unwell. Over the next four months the angina continued to occur from time to time, always passing. She didn't want to worry her children and tried to keep life as normal as possible. Then in January she went for her annual physical exam and shared her thoughts with her doctor.
"She appreciated my diagnosis but decided she was going to rule out cardiac anyway," Harmatiuk said, chuckling.
An ECG (electrocardiogram) showed nothing wrong. Then she did a stress test where she was hooked up to cardiac leads and a monitor while walking on a treadmill. Every two minutes the pace got faster and the incline more steep. She had no chest pain but nine minutes into the test she could no longer keep up.
The test was inconclusive and needed to be repeated, this time using a contrast medium.
"My doctor called me and told me that the technicians had seen a 90 per cent or greater obstruction in my left anterior descending artery," Harmatiuk said.
Scheduled to leave for a conference within an hour of getting the call, she didn't discuss the situation with her family before she left, first for the conference and then to visit her mother in Whitehorse.
The news had to settle in. The year before Harmatiuk had lost a kidney to renal cancer and she had had quite enough of health crises for the time being, thank you very much. So she stayed with her mother for a week and took the medication as prescribed.
An appointment for an angiogram in Calgary was scheduled for July 6 and Harmatiuk cancelled a trip to go on a bus trip with one of her daughters for soccer. However her condition worsened and the angina was occurring more often, waking her up at night with pain radiating into her arm and jaw.
"By this time I knew I had a cardiac issue but I really hadn't told people," she said.
The angiogram revealed two obstructions, one greater than 90 per cent and one greater than 70 per cent in two sections of the same artery. She had hoped a stent, a tube inserted into an artery to keep it open, would do the trick but bypass surgery was required.
"I was devastated," she said. "I had it all figured out. It was going to be a stent and all better."
With medications to manage the angina, she was sent home. Three weeks later she went back for double bypass surgery where two vessels were grafted to bypass the blockages.
Harmatiuk's symptoms were more typical of a man; women usually experience heartburn, indigestion, shoulder pain, fatigue or vomiting.
"Heart attack can manifest in a lot of ways," she said. "The only hope then is to get emergency help."
Harmatiuk had always taken care of her health so the blockages in her artery are a bit of a mystery. Harmatiuk had always had annual checkups, she never had high blood pressure, high cholesterol, hadn't smoked since she was 25 years old and never drank to excess.
"The surgeon did tell me I am a very tiny woman. I thought 'No I'm not, I'm five-foot-seven. I'm not a tiny woman.' But he said 'You have a very tiny heart and tiny vessels.'"
After the surgery Harmatiuk was off work for four months and participated in a cardiac rehab program through the heart function clinic at Chinook Regional Hospital. It included diet counselling, lifestyle changes counselling and exercise classes.
By the third week of December she was back to working 12-hour shifts. She consumes a diet of whole foods and has eliminated junk food. Fitting exercising into her schedule is still something she's working on.
Along with stressing the importance of diet, exercise, not smoking and not drinking to excess, Harmatiuk advises other women to not do what she did.
"Diagnosing cardiac disease is a process usually. It's not the first test that shows something; there's a number of things that need to be done and time goes by in that process. It's probably best you start early than late. Don't ignore those symptoms, easy to do, I get it. I did it. But I do not advise people to do it; it's not a good idea. I was very lucky that I did not just have a heart attack and die," she said.