It's impossible to know, unless you're Urban Meyer or one of his doctors, what exactly caused the two-time college football championship winner to see-saw decisions about his prestigious professional career and his family life.
But the scenario is all too common among Americans of all walks of life. Meyer just provides a high-profile reminder of how important heart health is.
"All too often, we see patients who have their wake-up calls after a serious heart attack. I think that we need to give Meyer credit for recognizing that heart health is a serious matter before he got to the point where it is too late for him," says Cam Patterson, M.D., MBA, chief of cardiology at the University of North Carolina at Chapel Hill School of Medicine and director of the UNC McAllister Heart Institute.
And, Patterson says, once faced with a potentially life-threatening cardiovascular problem it's common for people to think they have to pull back from their careers completely.
"Some people in high-level positions add more stress to their lives than they need to," says Patterson, who also is director of the UNC Center for Heart and Vascular Care and a noted geneticist.
Stress, Patterson says, has been shown repeatedly to contribute to cardiovascular disease. It increases blood pressure and signals the release of adrenaline, which can spark a heart attack.
But, stress doesn't have to force a decision between work and an early retirement.
"I've seen that over and over again with patients who have gotten serious about healthy eating habits and adopting a healthy lifestyle. They remain productive, or they become even more productive in their professions," he says.
"Overworking begets overworking. Neglecting healthy eating patterns begets unhealthy eating patterns. You need to break the cycle."
As for what causes heart pain over a period of several years, without causing a heart attack, Patterson says one possibility is small vessel disease, or microvascular disease. Over time, if not kept in check, it can lead to heart disease. But it's not as threatening as the blockage of large arteries in the heart and would not necessarily require hospitalization.
Thorough diagnostic tests, like a stress test to look for blocked arteries, an echocardiogram or monitoring heart rhythm, need to be done quickly, and any irregularity might lead to a hospital stay.
"There's nothing inherent in being a college football coach that inevitably leads to an unhealthy lifestyle and increased cardiovascular risk," Patterson says. "The thing to do is to look out for those aspects of that or any profession that contributes to unhealthy behaviors, wall them off and develop tools to protect yourself against them. (See below.)