ST. GEORGE — Last summer, Nick Shultz thought he had something bad to eat.

He was feeling nauseous, had a terrible case of heartburn that nothing could spell relief for and he could feel his heart about to pound out of his chest like a scene from “Alien.”

But Shultz was a fit 47-year-old who was an active runner skilled at jiu-jitsu and wrestling. So he figured it was going to get better. It didn’t. He was having a heart attack.

“I didn’t know I was having heart attack originally and that’s part of the issue is that I ignored the symptoms and through maybe denial, waited too long to go seek care,” Shultz said.

Shultz, who was on a trip to Idaho at the time, went to an urgent care there. He said he had heartburn and they treated him for the ailment.

“Honestly, I thought I had like a really bad case of food poisoning for a while, and that’s what it felt like for a day until I started getting kind of that tingling feeling in my left arm,” he said.

After the tingling, he went to an emergency room a day later where they found he had been having a heart attack for more than a day.

While COVID-19 came close to catching up in 2020 and 2021, heart disease has still managed to keep its top spot as the leading cause of death in the United States for old and young. But it’s the younger demographic that has been the biggest change.

A multi-state study of more than 28,000 people hospitalized for heart attacks from 1995 to 2014 showed 30 percent of those patients were young, age 35 to 54, according to the American Heart Association. More importantly, they found the people having heart attacks were increasingly young, from 27 percent at the start of the study to 32 percent at the end. And the increase was especially prevalent in young women.

The good news is that while the number of heart attacks among those 54 and younger has been increasing, the yearly total of deaths from heart attacks among those in that age group has been on a downward decline since 2003, and after a brief increase in 2020 and 2021 has gone down since.

Yet there are still people like Shultz who are baffled how they became a heart attack statistic before age 50. It was just as much a shock to his wife and five children.

“I have a healthy lifestyle and a happy lifestyle, and it just doesn’t quite make sense. How could this possibly have happened to me?” Shultz said. “I work out, I eat healthy, I don’t smoke. I do everything I should.”

‘Don’t ignore it’

Nicholas Wittwer, a cardiology specialist and physician assistant at St. George Regional Hospital, was among those who aided Shultz when he got back to Southern Utah. He has since helped Shultz adjust to post-heart attack life that includes medications with supplementation, a straight diet regimen and, as Shultz puts it, a lot of the exercise and active lifestyle he had been doing anyway.

Wittwer said the increasing amount of heart attacks in people below their 50s doesn’t mean every young person should suddenly be rushing to the ER if they feel a pain in their chest. But they shouldn’t ignore the signs or symptoms if they last longer than they should.

“If you’re a younger person that doesn’t have a lot of risk factors, when you’re having a little bit of burning in your chest, maybe the first thought isn’t, ‘Oh, I’m going to have a heart attack,’” Wittwer said. “If you think it’s heartburn and you’re taking Tums and you’re trying things and it’s not getting better, don’t ignore it. Teenagers are very extremely unlikely to have a heart attack, but we have had people in their 20s, people in their 30s, lots of people in their 40s.

“You can’t predict who’s going to have the heart attack and who just has the symptom, but if  you’re getting burning every time you walk up a flight of stairs, you can’t just ignore that.”

Despite a seemingly clean bill of health and an active lifestyle, Shultz had a silent killer inside he would have no idea about without a blood test. 

And he hadn’t had a blood test. 

Shultz’s cholesterol levels were building up. Wittwer said that was a likely factor in his heart attack. For that reason, he emphasized that making sure to get blood work as part of an annual check-up is vital.

“Your primary care doctor can help order certain screening tests to help risk stratify. There’s some blood work, blood testing. We have some newer modalities here at Intermountain with coronary artery calcium scores, cardiac pet CTS (computed tomography scan, an X-ray scan that creates a detailed scan of the heart), different stress tests that are available,” Wittwer said. “And if there’s ever a question with your primary doctor, we also have what they call a rapid-access cardiac expert line that your primary doctor can call and ask a question to a cardiology provider at any day of the week, Monday through Friday.”

People can also get a general idea if they are at risk for heart disease no matter their age with an online test put up by the parent company of St. George Regional Hospital, Intermountain Health.

The quiz, at this link, asks a few basic questions — mainly about family health history — to determine if someone is at greater risk for having a heart attack in their lifetime and then encourages people to make an appointment with their doctor if they do.

Why are younger people getting heart attacks?

There are many mysteries in medical science. The reason why younger people are getting heart attacks, Wittwer said, is not one of them. He said there are plenty of studies that say the answer lies in the drive-thru and the aisle of Cap’n Crunch and Lucky Charms at the market that kids from the baby boomers on have grown up with. 

It’s the food.

“You can read any studies about childhood obesity and different things and diabetes coming at younger ages,” Wittwer said. “ We go for the easy foods and the convenient foods, which are not always the healthy foods. The inexpensive foods are not the ones that are the healthiest for us. I do think overall the American diet is a huge factor in the prevalence of heart disease.”

He added that because Shultz didn’t eat the typical American diet – a healthy one – he might have had a heart attack in his 30s.

“He probably already delayed his heart attack by 10 years or more.”

Wittwer said genetics can’t be ignored either. That’s where that online quiz comes in. Someone might be able to escape their parents’ poor hairstyles from their high school photos or some of their music choices, but they can’t escape their parents’ heart history. There are factors, according to the Centers for Disease Control, where someone in their 40s could have the heart of an 80-year-old.

“(Shultz’s) dad had a heart attack in his 50s. Now he’s had one in his 40s,” Wittwer said. “His children need to be paying attention.”

But contrary to some corners of social media, Wittwer said there is little to no evidence COVID vaccine or other vaccines have been a reason for more heart attacks among those 50 and younger.

“We had heart attacks in young people before vaccines and before COVID, and we’ve had them after,” he said, noting that the number of heart attacks among those younger than 55 has gone down, if not plateaued since 2020. But the overall 15-year trend had already taken that number more than three times what it used to be before Y2K.

A warning to friends

Since his heart attack, Shultz has been spending a lot more time at the hospital. But it’s not just because of his follow-ups.

Already having had a marketing career in the health industry, Shultz became the hospital’s marketing manager last September.

But along with marketing his hospital, he’s marketing heart health with his family and friends.

“I’ve had some friends who don’t see a primary care physician, probably aren’t getting their labs done regularly on those annual visits,” Shultz said. “And now they’re thinking more like, ‘Maybe I should be checking into this. Maybe I can’t just be eating out every single night or processed food all the time. I’ve got to start thinking about these kinds of things.”

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