It Couldn't Be A Heart Attack—but It Was

Like everybody else, I've been bombarded by those American Heart Association ads telling us the danger signals of heart disease. And like everybody else my age, I conveniently assumed that heart attacks were reserved for those in their 60s and 70s or for out-of-shape, stress-filled, middle-level executives.

I'm fairly familiar with the subject because my father just suffered his second "myocardial infarction"—the medical term for heart attack. He survived it and is leading a reasonably normal life. Of course I'd talked to him about his attacks, and so that night a month ago when I first felt the violent chest pain, the numbing in the arms and fingers, the sudden sweating—it all seemed familiar to me. But I'm only 36, skinny, have never smoked, and my cholesterol count is low. I'm in great shape, my resting pulse is 52, and my blood pressure is low, even for a pro athlete. So it never occurred to me that I was having a heart attack.

Actually, there were three separate attacks on Monday night, July 30. I had arrived home in New York from a tournament in Europe the day before, still fighting the time difference a little, and so by 11 o'clock I was in bed. The pain came before I fell asleep. It was centralized in the middle of my chest, under my sternum. My immediate thought was that it was indigestion or heartburn, even though the pain was so severe that I had to get out of bed and walk around in a bent-over position. It lasted about two minutes, and then I felt completely normal, so I got back in bed.

Fifteen minutes later, it happened again in the same sequence, and after I went back to bed, the same thing happened yet again, another 15 minutes later. My wife Jeanne was downstairs the whole time, editing some photographs for an exhibition of her work, but as bad as the pain was each time, I never even considered telling her about it. You don't make a fuss over heartburn, right? I didn't even bother to mention it to her the next morning.

Besides, I had two clinics that day. The first one, with Vitas Gerulaitis at Crotona Park in the Bronx, went just fine, and by then I'd forgotten all about the night before. Why should I have given any serious consideration to danger signals for a heart attack? People like me simply don't get them.

That afternoon I had my second clinic, a four-hour stint with some travel agents for American Airlines at the East River Tennis Club. I had just finished playing an exhibition with the pro Butch Seewagen when the pain returned. I was able to go over to a fence and hang there, and I suppose most people thought I was just catching my breath. This time I couldn't kid myself; something was obviously wrong. But I had three more hours of the clinic to go, and so I went back to work. At five o'clock, though, as we were taking a break, the pain returned. This time it was even-more vise-like, more agonizing, and I could barely manage to say, "I'll be right back," and leave the group. This time the pain did not subside after a couple of minutes. Seewagen saw me in distress in the parking lot and told me that a doctor happened to be playing tennis at the club. He brought the doctor out, and as soon as I described the events of the past day, he insisted that I go to the hospital immediately.

To this day my doctors cannot explain why it happened—just that it did. It can only be racked up as one of those statistical anomalies that surface often enough to keep the experts from getting cocky. In fact cardiologists sound like weathermen when they diagnose borderline cases. In my instance, the probability that I had a heart attack was around 80%. This means that on a scale of 1 to 100 (with 100 being the basic, everyday three-weeks-in-the-hospital coronary) my symptoms rated an 80—and the doctors wouldn't even venture that until I'd been in the hospital for four days. But the more tests I take, the more other possibilities are removed. Probably my heart problem (a weakness in the back wall) was congenital. In any case, skinny, well-conditioned Arthur Ashe, 36, did indeed have a heart attack.

While the experts are still not absolutely positive I had an attack, I was immediately admitted to the hospital as a patient suffering one. The resident in the emergency room took one look at my electrocardiogram and decided that I was in grave shape. That is because I'm an athlete. An EKG is an easy and relatively cheap way of trying to diagnose an infarct, but the trouble is that athletes' hearts—the healthiest ones around—often come out looking crazy on the chart. So do the EKGs of young black males, according to my cardiologist, Stephen Scheidt. He also told me that if the most eminent cardiologist in the land were shown Wilt Chamberlain's EKG—without knowing his name, and without any other diagnostic tools—he would urge that an ambulance be dispatched to pick up the dying man.

Luckily, in my case, while everybody was swooning over my disastrous EKG, I remembered that I had had another one taken in the orthopedic wing of the same hospital a couple years ago when I had heel surgery. When they got that electrocardiogram, the doctors could see that my "normal" EKG was abnormal, so my abnormal EKG, which they had just taken, wasn't nearly as abnormal as they had thought.

No one could have blamed the resident in the emergency room for being alarmed when he saw my EKG. Probably it was the first time he had seen one for a professional athlete. There are no more than four or five thousand pro athletes in the country, and the nation's medical schools do not spend an inordinate amount of time studying the crazy EKGs of healthy young men. When was the last time you heard of a pro athlete having a heart attack during his or her competitive years?