Editor's note: This is the first of three stories that will tell of one man's experience with cardiology services at Sierra Nevada Memorial Hospital and CHW. It will take readers from his initial visit to the emergency room with chest pain, through heart surgery and rehabilitation.

“Getting old is no fun,” thought Joe Crawley as he tried to deal with a fallen pine tree last spring.

Crawley, who was usually very energetic, had to take multiple breaks. He was feeling incredibly tired. After going to bed, he felt a consistent burning sensation in his chest. He drove himself to Sierra Nevada Memorial Hospital (SNMH) and told the Emergency Department (ED) staff he was experiencing chest pains and sweating.

“My heart attack was March 28, 2011,” he said.

Crawley stated that the ED staff began treating him right away.

“A lot happens really quickly,” said Dr. Dawn Harris, MD, Emergency Department assistant director at the hospital. “Time is of the essence.”

In fact, Harris said if a person is experiencing the symptoms of a heart attack, calling an ambulance is a good thing. That way, the medicines can be started in the ambulance on the way to the hospital.

Crawley's health issues had begun much sooner than March. Around the first of 2011, his previous “cast iron stomach” had begun to give him problems. He was having stomach aches, side aches, had a cold, and then had the flu. He was diagnosed with diverticulitis, an infection of the upper intestines, and over a month or two, he began to experience that burning feeling in his chest, though he thought that was because of his shoulder acting up from an old injury.

Even though his mother had died of a heart attack, and his older sisters had heart problems, Crawley was a regular jogger who watched his diet. His cholesterol and triglycerides were good. There seemed to be many reasons why he could be experiencing pain – other than his heart.

“People misrecognize their symptoms,” explained Dr. Ryan Smith, the cardiologist who saw Crawley. “The body's not wired to know where pain is located.”

He said the signs of a heart attack can be stuttering chest pain, chest discomfort in the form of pressure or squeezing with physical exertion, and even at rest, the same symptoms can become more pronounced, more prolonged. In fact, Smith said that pressure or tightness in the chest is even more worrisome than a description of pain. Other symptoms include shortness of breath, sweatiness, and nausea.

Many times, there is known vascular disease with the patient. Other high-risk medical issues include artery disease and diabetes. Age is also a factor. The symptoms are more concerning when a man is 55 years old or older, or for women, 60 or older. If older siblings – like in Crawley's case – have experienced a heart attack, it also increases the risk.

When an individual experiences these symptoms, there is no way to guarantee that they're not coming from the heart, so it is typically suggested that he or she comes to the ED as soon as possible.

“The problem is most people come late to the dance,” said Smith. The issue with that is permanent damage to the heart.

All physicians providing care for patients at SNMH are members of the medical staff and are independent practitioners, not employees of the hospital.