Wouldn’t someone with a low blood oxygen level turn blue in the palms of the hands, upper cheeks under the eyes, etc.? It should be obvious. Saw it on myself and others during hikes at very high elevations (high altitudes) quite a number of times.
One would think so. . . in fact I did so turn blue during one of my heart attacks many years ago, so I have been doing a self-assessment for that very thing and, nope. No blueness.
That’s one thing I saw in my lady when her heart started failing when she had Takatsubo Syndrome five years ago. That’s also known as "Broken Heart Syndrome" and can kill one just as dead as a myocardial infarction if left untreated. It’s caused by a sudden adrenaline flood to the heart that shocks the upper left ventricle and leaves it completely stunned, shocked and incapable of pumping blood. My lady’s heart suddenly had only 15% heart function. She looked positively gray! Takotsubo Syndrome is the only heart failure one can recover from with proper treatment. It supposedly hits women, but I think that a lot of men who drop dead due to claimed MIs, which frequently don’t get autopsied, actually die from Takotsubo.
Speaking of heart issues in women. Women often don’t present myocardial infarction, heart attacks, with the same symptoms that men do. I had a very good woman friend who had a sudden onset of a cough with shortness of breath, which got worse when she lay down, and a slight ache in her shawl muscles of her shoulders. She asked me to see if she could get an appointment to see her doctor the next morning at the clinic. The appointments were full, but she could come into the walk-in clinic at 1pm. I picked her up and took her at 12:30 so she’d be in line to get in quickly. She was gray.
The triage nurse took one look at her and took her right back. No waiting. Put a four-lead EKG on her and a blood oximeter. EKG was fine, blood Ox was 75%! Nurse said, you need to go to the ER right now! She didn’t want to go. "I’ll just go home, it’s just a cough. I’m going home." I told her I thought she should listen to the ER nurse. She said, "I want to hear my doctor say that."
Doctor poked her head in and looked at her and said "you need to go to the ER, right now!"
It was about a 150 feet from the clinic, and she wouldn’t let them use a wheel chair. She walked over.
They saw her coming and had a chair waiting for her. They all thought she had a severe pneumonia and started working her up for that. They still hooked up an EKG. Everything there was ok.
They drew blood, did tests, told her they thought she had a really bad pneumonia. . . but nothing was touching it. Finally, a little, black (about four foot nothing) doctor from Nigeria said "To hell with that EKG! I’m going to run blood enzymes!"
About a half hour later all hell broke loose. . . Doctors and nurses were running all over the place. . . A doctor came in with a nurse to talk about incubating her. She didn’t like that idea. "I don’t look good with a tube down my throat." This was a woman who would put on makeup to go into surgery! I’m wondering why, what’s going on. . . A nurse pulls me aside and says were trying to find her a room in the ICU, Intensive Care Unit. . ."
I interrupt to ask why, what’s going on. She says "Because it’s not pneumonia, she’s had a massive heart attack.”
I’m stunned. I start calling to get a hold of her family. They move her into the ICU. I’ve gotten hold of her oldest son and he’s on his way when the cardiologist comes out. They’re busy getting her settled. I ask him "how bad is it?"
"It’s bad. She had it about 24 hours ago. They tell me she walked in here? I can’t believe that! Were you with her?"
"Yeah, i was. She walked in. She insisted in walking in. She just had a cough. When you say bad, are you talking about bypass? How many?"
"Sixty percent of her heart is gone! Are you SURE she walked in? I can’t believe it. . . We are in there starting a mainline into her heart and she’s watching the World Series rooting for the Yankees! I can’t believe she walked in! Her enzymes were higher than any I’ve seen in 25 years of practicing cardiology, and she’s not unconscious... you sure she walked in?”
"Doctor? Are you going to be doing bypass surgery?”
"Bypass? No. We are just going to be trying to keep her alive until tomorrow to see if there’s a heart available for transplant! And she’s watching the World Series. . . Oh my. . ."
Just then the PA blared "Code Blue ICU, Code BlueICU” and people popped out of the woodwork from everywhere and headed deliberately to the ICU room where my friend was been prepped and had been watching the last game of the World Series. I was watching outside the big sliding doors. They worked on her for over a half hour before calling it. . . but the strangest Twilight Zone thing was that through it all, even with a full twelve lead EKG, she had a perfect trace. . .even after they called it, and the echocardiogram showed no motion from her heart. The cardiologist pointed to it and asked "Does any one here have any kind of a sane explanation for that?" He looked around the ICU room at a lot of pale faces.
One nurse spoke up, "She had the strongest will to live I’ve ever seen!"
Fifteen minutes later the Yankees won the World Series. That EKG signal kept going until the tech turned it off. I asked the cardiologist about it and he said he’d never seen anything like it in his 25 years of practice. The EKG had kept them from an earlier diagnosis until Dr. (the little Nigerian lady) tossed out the obvious evidence in front of her eyes and took a wild assed guess it WAS a heart attack, and then still didn’t show anything wrong all the way through her heart actually dying before their eyes. He said "I have no explanation and we’re having everyone involved write up their experience and observations of this case. No one with 60% of their heart gone should have been able to have walked in here. I don’t understand it at all. It’s one for the books."
The upshot of this is that women do not present heart attacks in classic ways. Don’t take chances.