Joyce Chicoine died on her daughter’s living room floor nearly nine years ago.

The 84-year-old Missoula resident said she was in California and had earlier gone to the emergency room because of anxiety and what the doctor diagnosed as acid reflux before sending her home.

Instead, she had a heart blockage that was not discovered until after her daughter performed CPR on her for more than eight minutes, until paramedics arrived and she again visited the ER.

In December, Chicoine again felt anxious and after she fell twice and once passed out in her apartment, she went to the emergency room at Providence St. Patrick Hospital, where she is also a regular volunteer.

She was having a heart attack but did not display any of the symptoms typically associated with one, despite her heart beating 200 times a minute.

“I didn’t know, and since I’d been healthy for 8 1/2 years I didn’t really think of the heart,” Chicoine said.

Now Chicoine has a pacemaker and continues to fill her days with an active volunteer schedule, and she said she wants other women to advocate for themselves and their health.

“We don’t want to be foolish running to the emergency room. We delay going, trying to figure out what’s going on,” she said, adding women should trust their instincts.

“We don’t want to admit it and we don’t want to go to the ER, but I think we know as women because we’re so intuitive. I think we know that something’s really wrong,” she said.

Chicoine’s tale is not an unusual one, said Dr. Jocelyn Spoon, a cardiologist with the International Heart Institute of Montana who was one of Chicoine’s doctors during her most recent hospital stay.

Only 35 percent of patients who come to the emergency room with heart attacks say they have chest pain, Spoon said.

Symptoms – especially in women – can be more obsequious, and include anxiety, nausea and chest tightness, she said.

“And that’s often what I hear from women. They can’t tell you what is wrong. They just know that something is wrong,” she said.

On Saturday, Spoon will talk about what other symptoms might be and how to discern if an emergency room visit is a good idea during the 2015 Heart Expo, put on by Providence St. Patrick Hospital and the International Heart Institute.

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Women are less likely to say they have chest pain and more likely to experience chest tightness or soreness, particularly in the back and upper chest instead of on the left side of their chest as is typically considered a warning sign of a heart attack, Spoon said.

Unusual fatigue and sleep disruptions also are signs of a heart attack, she said.

Women also are less likely to go to the emergency room and are more likely to wait longer than men to seek medical attention, Spoon said.

“It just doesn’t seem to be a priority for women,” she said.

Heart disease, though, is the No. 1 killer of women, she added.

Being active is critical to determining the severity of symptoms that could be related to a heart attack, Spoon said.

“It really just gives you a nice gauge, a nice baseline,” she said.

Know your family history and health conditions, which are important pieces of information for doctors when they work to diagnose the problem, Spoon said.

If people think they are having a heart attack, they should contact their doctor to talk over symptoms or go to the emergency room, she said.

“Don’t wait. You know your body. If you know something’s wrong, get in there,” she said, adding that if you are not satisfied with a doctor’s diagnosis, persist.

The Heart Expo begins at 7 a.m. in the Broadway Building Conference Center, with opening remarks at 8 a.m.

Spoon’s talk begins at 8:10, followed by “The Broken Heart” with Dr. Ashley Mays at 9.

At 9:50 a.m., Dr. Brad Berry will talk about managing heart failure and Dr. Michael Reed will present “TAVR: Lessons from the First 100 Cases” at 10:40 a.m. Closing remarks begin at 11:30.

The annual event usually draws roughly 1,000 people and offers demonstrations and information on heart health, as well as low-cost screenings.

Blood screens for lipids and glucose will be available for $5 and Prostate Specific Antigen and Thyroid Stimulating Hormone tests will be $10. People who want tests done should not eat or drink anything 12 hours before, and refreshments will be provided afterward.

This year, the University of Montana spectrUM Discovery Area will also bring a Hands on Health exhibit, with a health assessment station, life-size medical teaching torso and guided heart dissections.

Expo attendees can complete a short heart risk assessment online before talking with providers at the event at providence.org/myriskmyhealth.

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