Between work, family and sports, Beth Lastinger is almost in constant motion. The 45-year-old mother of three plays tennis several times a week and loves to ride her bike.
"I've always considered myself in pretty good shape," said Lastinger, an attorney for the Pinellas County Sheriff's Office. "We are an outdoor family and we do a lot of hiking in the mountains of North Carolina. I have always felt that I could pretty much do anything."
Lastinger's husband and their three boys — a 9-year-old and 6-year-old twins — all competed in triathlons.
She saw that an event was coming up in Safety Harbor on Oct. 30 and signed up.
"I was the only one in the house who hadn't completed a triathlon," she said. "So I figured why not . . . I'll do one."
Lastinger did her triathlon. But she also suffered a health crisis so subtle and surprising, it took her days to realize she was in serious trouble.
Now she's speaking out to let others know that heart attacks don't always announce themselves loudly with crushing pain. They also can arrive quietly, with symptoms that are easy to brush off.
START OFF SMALL
Most doctors recommend starting off slow with any exercise program. Lastinger figured she was being smart by picking a "sprint" triathlon, which is considered a good introductory distance for most first-timers to the sport.
"I knew I could run 3 miles and ride 10 miles without much difficulty," she said. "But I really didn't think much about the swim."
The quarter-mile swim in Tampa Bay is the distance equivalent of less than 14 lengths in a 25-yard pool. But swimming in the chilly, open water — with waves, current and hundreds of other people jockeying for position — can cause a rookie triathlete a lot of stress.
"I didn't train at all for the swim," she said. "And right away I knew something wasn't right."
Lastinger's chest began to feel tight, but she wasn't used to swimming in a wet suit, and figured it was just a little snug.
Despite her discomfort, she carried on.
"I knew something wasn't right but I kept going," she said. "I felt weird on the bike and run too but I still finished the race."
CAUSE FOR CONCERN
After the triathlon, the feeling passed. Lastinger went home, gathered up her kids, and they all rode their bikes a couple of miles to downtown St. Petersburg.
"We stopped, had lunch . . . it was like nothing ever happened," she said.
But then three days later, at her regular Wednesday night tennis match, she started feeling nauseous.
"I had to stop playing," she said. "I just chalked it up to having a long day at work and not eating enough."
The next morning, as she was walking into work, the feeling returned. Lastinger sat down for about an hour, pain radiating down her left arm. Her chest felt heavy and she experienced a sense of "impending doom."
That's when a colleague stepped in and urged her to go to the hospital. A few minutes later she was on her way to Largo Medical Center.
"I walked in, said my chest hurt, and they rushed me back," she said. "I don't remember much else . . . they said I was having a heart attack."
Lastinger left the hospital with two stents in her heart. Her doctors were not sure what caused the heart attack. One theory was that a piece of vulnerable plaque broke off and blocked an artery.
Another theory was that Lastinger simply overdid it. The stress of the exercise caused the artery to tear apart. Her body tried to block it by creating a clot, which restricted the artery and triggered the heart attack.
That notion makes sense to her.
"I wasn't overweight," she said. "I didn't have a cholesterol problem. There was no plaque buildup. My body was just overloaded."
Lastinger said she was encouraged by the American Heart Association to share her story to help educate people. Heart attacks are rare in women as young and healthy as Lastinger, but they do happen, and so it's worth knowing your risk factors and the warning signs.
If you have a history of heart disease, you're older or you've been sedentary for a long time and want to become active, the medical advice is straightforward: Talk to your doctor.
"It is easy to bite off more than you can chew," said Dr. Jeremy McConnell of Bayfront Primary Care Associates. "It is always a good idea to see your doctor, get on a treadmill and see what you can do before you head out and try to do a half-marathon."
But if you've always been active and healthy, like Lastinger, getting a cardiac stress test before taking up a new activity may be the last thing on your mind.
Her takeaway message: Take the gradual approach to new sports so you learn your limits and you can tell right away when something doesn't feel right.
"You have to train," she said. "You can't take it for granted."
Terry Tomalin can be reached at firstname.lastname@example.org.