The Triton


Sometimes simple symptoms can be signs of something worse


Recently, my friend Capt. Rob noticed he was feeling tired earlier in the day. He was also sweating more than usual but, being out in the hot Florida sun working, that did not raise any concerns.


About the same time, he noticed indigestion or heartburn so he started taking Zantac. He wasn’t sure what it was but he knew he did not feel well.


After several days of this, he decided to go to the doctor. Upon his arrival to the doctor’s office, he was informed that he was having a heart attack. Happily, my friend survived.


While teaching a class in Pennsylvania last month, a student shared a similar story. When he was only 40 years old, he started to experience really bad heartburn and indigestion. He started to drink Maalox antacid. For two weeks this feeling continued, and he continued to drink the Maalox.


One morning, a new symptom began. He said it felt like someone stabbed him with a 2×4 between the shoulder blades and lit it on fire. At this point, he dialed 911, and was flown by helicopter to the hospital for surgery. Happily, he survived.


Many, however, are not so fortunate, especially those who wait too long.


These two stories are not uncommon. Chest pain may be an indication of a heart attack or it may only be heartburn. The problem is that it can be difficult to tell the difference.


Sometimes our body sends signals to the brain that don’t always sound logical. I had two students who experienced heart attacks, and they both felt the pain in their elbows. Normally, we don’t associate elbow pain with heart attack, but it can happen.


Chest pain can be a heart attack, but it can also be a gastrointestinal problem such as ulcers, muscle spasms in the esophagus, GERD, a gallbladder attack, or pancreatitis. Often, these conditions can cause chest pain and symptoms that are similar to a heart attack or angina.


Angina is chest pain or discomfort that occurs if an area of your heart muscle doesn’t get enough oxygen-rich blood. Often, angina feels like pressure or squeezing in your chest. Some patients describe it as though an elephant were sitting on their chest. The pain also can occur in the shoulders, arms, neck, jaw, or back. And angina pain may feel like indigestion.


Part of the problem in detecting where the pain is coming from is that the nerves in the chest are not as well tuned as those in our hands. Your brain knows which hand or finger hurts. But when the chest hurts our brain often has difficulty determining if it is the heart, lungs, pancreas, esophagus, or stomach. The brain just knows the chest hurts.


The key is to recognize the symptoms early and seek immediate medical attention. The longer you wait for medical treatment, the greater the chances the situation will worsen and potentially lead to death. I always tell my students “If you delay or deny, you can die.”


The problem is that most of us can’t usually tell if these symptoms are from something innocuous like heartburn or if it’s as serious as a heart attack. Often only trained professionals can tell the difference.


If you notice these symptoms in any of your guests or crew mates while at the dock, seek medical treatment before departure. If you notice these symptoms while at sea, contact a doctor immediately via satellite phone or radio.


Keith Murray, a former firefighter EMT, owns The CPR School, a first-aid training company. He provides onboard training for yacht captains and crew and sells and services AEDs. Contact him at 877-6-AED-CPR, 877-623-3277 or Comments on this column are welcome at


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