What exactly is a 'widow-maker' heart attack, like Kevin Smith had?

<i>Photo via Instagram/thatkevinsmith</i>
Photo via Instagram/thatkevinsmith

You know that expression “listen to your body”? Filmmaker Kevin Smith does, having followed that piece of advice recently — saving his life in the process.

The “Clerks” director performed the first of two shows in Glendale, Calif. on Feb. 25 before deciding to seek medical help because he wasn’t feeling well. Turns out he survived what’s known as a “widow-maker” heart attack.

“The doctor who saved my life told me I had 100 per cent blockage of my LAD artery (aka “the widow-maker”),” Smith wrote on social media, along with a hospital-bed selfie. “If I hadn’t cancelled show two to go to the hospital, I would’ve died tonight. But for now, I’m still above ground!”

ALSO SEE: Kevin Smith hospitalized after suffering ‘massive’ heart attack

I was trying to do a killer standup special this evening but I might’ve gone too far. After the first show, I felt kinda nauseous. I threw up a little but it didn’t seem to help. Then I started sweating buckets and my chest felt heavy. Turns out I had a massive heart attack. The Doctor who saved my life at the #glendale hospital told me I had 100% blockage of my LAD artery (also known as “the Widow-Maker” because when it goes, you’re a goner). If I hadn’t canceled the second show to go to the hospital, the Doc said I would’ve died tonight. For now, I’m still above ground! But this is what I learned about myself during this crisis: death was always the thing I was most terrified of in life. When the time came, I never imagined I’d ever be able to die with dignity – I assumed I’d die screaming, like my Dad (who lost his life to a massive heart attack). But even as they cut into my groin to slip a stent into the lethal Widow-Maker, I was filled with a sense of calm. I’ve had a great life: loved by parents who raised me to become the individual I am. I’ve had a weird, wonderful career in all sorts of media, amazing friends, the best wife in the world and an incredible daughter who made me a Dad. But as I stared into the infinite, I realized I was relatively content. Yes, I’d miss life as it moved on without me – and I was bummed we weren’t gonna get to make #jayandsilentbobreboot before I shuffled loose the mortal coil. But generally speaking, I was okay with the end, if this was gonna be it. I’ve gotten to do so many cool things and I’ve had so many adventures – how could I be shitty about finally paying the tab. But the good folks at the Glendale hospital had other plans and the expertise to mend me. Total strangers saved my life tonight (as well as my friends @jordanmonsanto & @iamemilydawn, who called the ambulance). This is all a part of my mythology now and I’m sure I’ll be facing some lifestyle changes (maybe it’s time to go Vegan). But the point of this post is to tell you that I faced my greatest fear tonight… and it wasn’t as bad as I’ve always imagined it’d be. I don’t want my life to end but if it ends, I can’t complain. It was such a gift. #KevinSmith

A post shared by Kevin Smith (@thatkevinsmith) on Feb 26, 2018 at 1:41am PST

So what exactly is a widow-maker heart attack — and why is it so deadly?

Like other tissues in the body, the heart muscle needs oxygen-rich blood to function. Coronary arteries run along the outside of the heart and have small branches that supply blood to the heart muscle.

The LAD artery that Smith was referring to is the left anterior descending artery, which supplies blood to the front of the left side of the heart. Of all the branches that deliver blood to the heart muscle, the LAD is typically considered the most important.

“When it comes to coronary disease and the arteries, it’s location, location, location,” says Dr. Saul Isserow, director of the Vancouver General Hospital Centre for Cardiovascular Health and the director of cardiology services at UBC Hospital. “The LAD provides a tremendous amount of blood to the heart muscle.”

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“People [who have heart attacks] often have no preceding warning signs or symptoms,” he adds. “When someone says ‘I had a heart attack 10 years ago,’ they’re one of the lucky ones.”

That’s because approximately 50 per cent of first heart attacks are fatal.

While a widow-maker heart attack is particularly dangerous, its title is a misnomer; it’s just as likely to be a “widower-maker.”

“When the term ‘widow maker’ is used, it perpetuates the notion that coronary disease is mostly a male disease, and that is not the case,” says Isserow. “In fact, coronary disease is the epitome of an equal-opportunity disease.

“It is often fatal and can affect people in the prime of their lives,” he adds. “You’re not protected because you’re young.”

Although many people don’t experience symptoms prior to a heart attack, Smith did. He said on social media he felt nauseated, that his chest felt heavy, and that he started sweating profusely.

Other signs of an LAD or other types of heart attack are the same. They can include shortness of breath, dizziness or light-headedness, fatigue, heartburn, abdominal pain, and pressure, tightness, pain, or a squeezing or aching sensation in the chest or arms that may spread to the neck, jaw or back.

ALSO SEE: ‘I had a heart attack on the way to my wedding’

Some heart attacks occur out of the blue, while some people have symptoms hours, days or even weeks in advance. The first sign may be angina — recurrent chest pain caused by a temporary decrease in blood flow to the heart — that’s triggered by exertion and eased by rest.

Smith survived because he paid attention to the warning signs.

“The most important health message here is that he did the right thing,” says Dr. Beth Abramson, spokesperson for the Heart & Stroke Foundation. “On social media he talked about how he listened to his body. With the heaviness in his chest he did not go on to do that second show.”

“Over the years, I’ve seen too many tragedies because people didn’t seek medical attention,” adds the director of the Cardiac Prevention and Rehabilitation Centre and Women’s Cardiovascular Health in the division of cardiology at St. Michael’s Hospital in Toronto. “I literally had a patient this week who was worried enough she was having a heart attack — she woke up with chest heaviness, sweating and was short of breath — that she unlocked the front door in case the ambulance had to come then went back to sleep. We have excellent health care in Canada but we have to access that care.”

Abramson notes that nine in 10 Canadians have at least one risk factor for heart disease or stroke. Those risk factors include smoking high blood pressure, high cholesterol, lack of exercise, obesity and diabetes.

Up to 80 per cent of premature heart disease and stroke is preventable by eating a healthy diet, being physically active, limiting alcohol consumption and not smoking.

Canadians can calculate their risk of having a heart or stroke online here.

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