"Nothing concentrates a man's thoughts so much as the knowledge that he is to be hanged on the morrow" [Samuel Johnson}

A Glass of Water for a Heart Attack?

          It had come out of the blue -- sudden hot pain behind
the lower part of the sternum, which had flashed left, right, up
and down till it had engulfed his whole chest and quickly grown
so intense that he could barely breathe.  It had felt as though
bands of steel had been laid about him.  And he had broken out in
a cold sweat though he could not have told whether the sweating
was part of what had befallen him or a secondary effect, one of
fear that he was in the middle of a heart attack.
          At Emergency, the doctor had taken his blood pressure
and checked his pulse.  "125/70 against a heart rate of 68," he'd
heard the doctor mutter; "no indication of heart trouble there."
The ECG had turned out reassuringly regular.  For good measure,
an X-ray and a blood sample had been taken, neither of which had
shown anything irregular.  Whatever it had been, it did
not seem to have come from the heart.  Moreover, even before they
had quite finished with him at Emergency, the pain had
disappeared, no more than a hint of it left as though to confirm
that it had not just been his imagination.  He had left Emergency
almost reassured that he was all right.  
          He had gone through it all again a few weeks later
-- the sudden pain that spread from an epicenter behind the lower
sternum, the checks at Emergency, the doctor's conclusion that
there was nothing wrong with him.  In a little follow-up chat,
the doctor had suggested that his problem might be psychosomatic,
the result of too much stress.  
          When, trying to describe the pain to me, he used the
words hot and burning several times, I had a hunch.   Yes, he
said, when I asked him about heartburn, he knew what a heartburn
was, but the pain he was talking about was nothing like a
heartburn.  While a heartburn was mostly burn, what he had
experienced had been almost all pain, though with perhaps a hint
of burning in it.
          I remembered that, though the normal response to
stomach acid backing up into the esophagus is a heartburn,
medical literature reports cases where the esophagus responds to
the acid with spasms accompanied by pain so intense and massive
as to mimic a heart attack.  I told him of my hunch and advised
him to treat his next "heart attack" with a big glass of water --
water at room temperature, not iced, to be drunk slowly but
continuously, in hopes that it would wash the acid out of the
esophagus and so, by eliminating the cause, ease the pain.  
          A few weeks later I had a phone call from him.  He had
had another one of his "heart attacks" and he had tried the water
therapy.  The results had been spectacular.  The first sips of
water had barely reached the lower end of his food pipe, when the
tightness around his chest had loosened and the pain disappeared
as though it had never been.  No need for a trip to the
Emergency.  His excitement was palpable.
          Now, I am not suggesting that anyone experiencing a
sudden burst of massive pain radiating from behind the sternum
should do no more than slowly drink a glass of water.  My advice
to him is that he had better get himself to Emergency the
quickest way possible.  He might, on his way there, take several
deep breaths, breathing in normally but exhaling with bursts of
deliberate coughing.  If he should be in the throes of a real
heart attack, the coughing would, by massaging the heart, help it
keep beating till he should get to where expert first aid is
available.

If the doctors should find nothing wrong with his cardiovascular
system, if they should wonder whether stress might be at the
bottom of the complaint, he might try the water treatment.  
If his problem is esophageal spasms due to acid backup, the
water therapy is bound to help and it will, ex iuvantibus,
corroborate the diagnosis.