On July 31, professional tennis player Arthur Ashe checked himself into New York Hospital after suffering a series of chest pains. The diagnosis: at age 36, Ashe had suffered a heart attack. Now, a month after the attack, Ashe recalls the episode, describes what it has meant to him and tells what it might mean to others.
Normally, people with heart attacks don't walk into hospitals. They usually arrive in ambulances. The fact that I arrived under my own power was a plus.
Describing my problem to the resident physician in the emergency room -- I had suffered chest pains five times in the preceeding 18 hours -- brought medical questions with machine-gun rapidity: How long have you had the pains? Where are they? Did it feel like a vise? Or is the feeling one of intense pressure? It is localized? Are you on drugs? Are you allergic to anything? Have your father or brothers had heart attacks or heart problems?
As an apparent heart attack victim, I wasn't given a lot of forms to fill out or asked questions about my health insurance.
Instead, I immediately was given an electrocardiogram (EKG), hooked up for an intravenous feeding and was given morphine to kill the pain and other medications to help the heart and to prevent arrhythmia (irregular beating), which is the chief concern following a myocardial infarction or heart attack.
All of this took about five minutes. Meanwhile, my mind was racing as fast as the medics. I thought of all sorts of things -- all bad, debilitating and permanent. Stroke. Bypass operations. No-salt diets. No more tennis.
Worse yet, dying.
I even remembered reading somewhere that heart attacks in the 30s are usually fatal because the heart and its feeder system have not had enough years to establish alternate routes for the blood supply.
And there was another nagging thought.
During the entire episode -- in the car on the way to the hospital, in the emergency room and during the four days in the intensive care and cardiac care unit -- one thought recurred: Why me?
The why-me question was more than just a complaint from someone who felt cheated by fate. It was a serious question.
I'm not your typical heart attack victim. My blood pressure is below normal. I don't smoke or take drugs. I'm thin. My serum cholesterol count is low. I'm not hypertense. I have no trouble absorbing sugar. And with all the tennis I play, I'm about as physically fit as a 36-year-old man can be.
Maybe all of this explains why I didn't pay much attention at first to the chest pains. The first four incidences of pain lasted two minutes apiece and disappeared -- I thought for good.
I had started to sweat, but I wasn't short of breath. I felt some pain in my arms and I made a vague connection to my father's recurring symptoms.
But I'm a pro athlete -- no way I'm having a heart attack.
But then the fifth pain came. It occurred while I was giving a tennis clinic. It was more intense than the others -- it nearly made me cry -- and it didn't go away as readily. That's when I headed for the hospital.
With all the questions I had about my attack, I was in the right place. New York Hospital is a teaching institution affiliated with Cornell University. There were plenty of doctors to talk to and they didn't seem to mind my questions. I was given a ton of books, brochures and pamphlets, along with the latest medical opinions about heart attacks and their related problems.
The answer to my big question -- why me? -- seemed to boil down to family history and random chance.
My father has had two heart attacks, his first at age 55. He had his second a week before I had mine. A male is particularly susceptible to a heart attack early in life if his father had one early too.
The doctors tell me I probably have a tiny congenitally weak spot in the back wall of the left ventricle of my heart. A congenital problem arises by chance at birth but is not inherited.
Beyond heredity and chance, a serious factor to be considered in my attack is exercise, I've played tennis 2 1/2 hours a day, six or seven days a week, for the past 13 years.
So, if I can have an attack, what does that say to the person who is my age or a bit older and leads a sedentary life with little or no physical exertion at all? And perhaps more alarmingly, what does it say to the person who is in his 30s or 40s and just took up jogging to recapture the fitness he enjoyed at 20?
If you're not physically active, should my experience cause you to smile and relax in your easy chair? Or, if you're out there killing yourself trying to run two miles a day, should you quit?
The answer lies somewhere in between.
The fact that I am physically active did not bring on my attack. Indeed, the doctors tell me that my physical condition probably kept the attack from being more severe. It may even have saved my life.
My doctors confirmed for me what you've been hearing often in the era of the jogger -- if you're basic health permits it, periodic, graduated and intense physical exercise is good for you. It keeps the arteries open, delivers more oxygen to the heart muscle, relieves tension, helps the body process sugar and helps the lungs function properly.
The current thinking is that 30 to 45 minutes of intense physical activity four days a week is about the right schedule. But based on your age, race, sex, weight, family history, diet and medical history, a doctor can tell you how much exercise you can do to protect your cardiovascular system.
And if you are a parent, think about your children's cardiovascular systems too.
Arteriosclerosis, or narrowing of the arteries, begins in childhood. It startled me to learn that some evidence of arteriosclerosis was found in about 45 percent of our Vietnam war casualties, a relatively young group of men.
So what lies ahead for the recuperating 36-year-old professional athlete? Some time in the next two months an angiogram will be performed on me. That involves inserting a catheter into the arteries around the heart to find out if they are damaged. My doctor does not expect to find much wrong; but to be on the safe side it must be done.
Assuming I pass the test, a graduated conditioning program will be mapped out for me around the beginning of November. In the meantime I am walking about normally, eating what I want, taking French lessons and going to the Sports Training Institute here every day to stretch for about 40 minutes.
The angiogram will help establish just where I go from here. But right now I plan to start playing competitive tennis again at the U.S. Pro Indoor tournament in Philadelphia the third week in January.
It will then be five months since my attack, and I'm looking forward to re-establishing myself where I left off -- among the top 10 tennis players in the world.