It wasn't the herring – it was a heart attack. Good thing he remembered a video about symptoms.

In May, Tony and Katie Gnau flew to Amsterdam in celebration of their daughter Betsy's 13th birthday.

The first few days, they strolled the canals and toured the Anne Frank house. On the third day, the family pedaled 18 miles into the Dutch countryside, past windmills and picturesque fishing villages.

Tony, a Wisconsin-based corporate communications speaker and video producer, enjoyed eating local cuisine. For instance, after the bike ride, he picked up a pickled herring sandwich, complete with onions and pickles.

Back at the place where they were staying, Tony enjoyed the meal. When he felt intense pressure in his chest soon after, he figured it was heartburn from the herring.

The pain intensified. Then his lower jaw was suddenly sore. He'd never experienced jaw pain like it before.

When he told Katie what he was feeling, she said, "Oh, it's probably the herring."

Tony lay down to see if it would pass. While resting, an image of a woman moving her jaw and talking about heart attacks flashed before his eyes. He couldn't remember where he'd seen it.

But at that moment, he knew. He was having a heart attack.

Tony got up and found Katie. "You may think this is crazy, but I think I'm having a heart attack," he said. "We should call 911."

"Are you joking?" said Katie.

A heart attack seemed unlikely given Tony's overall health. At 51, the former college athlete – he was a walk-on for the University of Southern California's football team for four years – worked out three or four days a week and ate a healthy diet.

Tony shook his head; he wasn't joking.

Katie looked up the 911 equivalent in the Netherlands. It's 112, and she dialed immediately. The operator spoke perfect English. Upon hearing Tony's symptoms, she said: "I'm sending the paramedics right away."

When first responders arrived, they did an electrocardiogram, or EKG, to check the electrical signals in Tony's heart. The test confirmed his suspicion: It was a heart attack.

There was one small problem. The stretcher wouldn't fit up the canal home's narrow staircase. EMTs called the fire department.

Firefighters used a ladder and special stretcher to lower Tony from the fourth-floor window to street level. Cars trapped on the narrow road below honked incessantly.

Although Tony knew every minute counts when responding to a heart attack, he remained calm. He felt like he was ahead of the game because of how quickly he'd been diagnosed. He asked Katie to take pictures of the firefighters' device, sure that his dramatic rescue would make a good story one day.

In the ambulance, Katie sat in back with Tony, with Betsy in the passenger seat. The driver tried keeping her mind off her dad by asking about school and life back home.

At the hospital, Tony underwent a procedure called a cardiac catheterization. A doctor threaded a catheter through blood vessels in his wrist to his heart. He cleared out a blockage in one small artery. But then he made a bigger discovery.

Tony had blockages in three of the main arteries that supply oxygen-rich blood to the heart. Doctors said he probably needed triple bypass surgery. It's a procedure that creates a new way for blood to flow around clogged arteries.

The surgery didn't have to be done in the Netherlands, though. Because Tony wasn't imminently at risk of another heart attack, they said he could go home and see a cardiologist there.

While recovering in the Dutch hospital, Tony realized where he'd seen the image of the woman. It was from an American Heart Association video featuring actress Elizabeth Banks. Tony saw "Just a Little Heart Attack" during the closing keynote of a major marketing conference he'd spoken at the prior fall.

Banks plays a working mom rushing to get her kids ready for school when she has a heart attack. At the conference, she spoke about how proud she was of the video, which teaches people about heart attack symptoms in women, which can differ from men.

The video wasn't made for Tony's demographic, per say. But it had stuck with him. He hadn't realized jaw pain was a heart attack symptom.

Tony was ready to leave the hospital three days after arriving. However, airline policy led to several more days of waiting for clearance from his doctors.

They made the most of their time. After sending Betsy home to stay with a family friend, Tony and Katie toured the Hague and saw Johannes Vermeer's "Girl With a Pearl Earring" painting. Tony took it slow. He avoided any herring dishes, too. Just in case.

Finally, nine days after Tony's heart attack, the couple boarded a flight home.

Katie's eyes were locked on the flight map. She worried about where they would land if Tony had another heart attack, especially as they drifted over the Atlantic.

But they made it home safely.

Tony consulted several doctors before coming up with the game plan that made the most sense to him. In August, he underwent a successful quadruple bypass, meaning doctors routed blood around one more blocked artery than the original diagnosis in the Netherlands.

Tony went home four days later. He plans to be homebound for a month to recover. Already, he's walking four times a day and doing basic stretching and calisthenics.

In the meantime, the family's already healthy diet got healthier. Tony cut out meat and eats a plant-based diet. He's paying attention to how much saturated fat and sodium he consumes.

Recent bloodwork showed that since Tony improved his diet in early June and started cholesterol medication, his cholesterol levels have improved. He also learned an important fact: Heart disease runs in his family. One of his grandfathers died from a heart attack when Tony was a toddler.

Tony also reached out to organizers of the conference where he saw the "Just a Little Heart Attack" video to thank them. He asked them to thank Banks, too.

"That video," he said, "it saved my life."

Stories From the Heart chronicles the inspiring journeys of heart disease and stroke survivors, caregivers and advocates.