Silent heart attacks: Why you need to be aware

When anyone thinks of a heart attack, we all think of pain in the chest and down the left arm. But did you know that you could suffer from a heart attack and not even know it? Known as a ‘silent hea

By: Dr Vijay Surase | | Updated: April 1, 2015 12:26 pm

When anyone thinks of a heart attack, we all think of pain in the chest and down the left arm. But did you know that you could suffer from a heart attack and not even know it? Known as a ‘silent heart attack’, the phenomenon is quickly becoming very common. Also Read - Virtual reality can enhance treatment using 3D images from a patient's blood vessels

Silent heart attacks are the same as any other attack, but the person just doesn’t feel it. This is usually because of possible nerve damage or neuropathy around the heart due to long term diseases or narrowing of the coronary arteries (the main arteries of the heart) which impedes blood flow to the heart. Ironically, people who are at high risk for heart attack are most susceptible to suffer from a silent heart attack. Also Read - Heart attack and sudden cardiac arrest: Here's what you need to know

Read more about causes, symptoms, diagnosis and treatment of heart disease. Also Read - Being absentminded can indicate a silent stroke, reveals study

Risk factors include:

Diabetes
High blood pressure
Smoking
Family history of heart trouble
High cholesterol

Symptoms:

A silent heart attack is when the person does not experience the usual chest pain, chest discomfort or shortness of breath, etc. and the person who experiences it may not realise he’s suffering from a heart attack.

Some of the most common tell-tale signs are — feeling increased fatigue after normal activities, shortness of breath and sleep disturbances, persistent feeling of indigestion, burping, bloating of the stomach with no history of gastric disorders.

Because a patient may not be able to identify the exact reason for the discomfort, most doctors cannot treat the patient within the ‘golden hour’ or golden 90 minutes’ (a term used to describe the crucial 90 minutes after the attack during which the patient is most likely to make a full recover), leading to a lower heart pumping rate. Another risk these patients face is the fact that they are susceptible to recurrent episodes which could lead to heart failure, pump failure and congestive heart failure.

Diagnosis:

In most cases a silent heart attack is not diagnosed until after it happens. Here are the tests that a doctor would use to diagnose this condition:

An electrocardiogram (ECG),
2 -D ECHO-color Doppler ,
The presence of cardiac enzymes (proteins which are released by the dead heart muscle) which are usually elevated in case of a heart attack.

Treatment:

Medications that thin the blood and make it easier for blood to travel through the arteries.
Anti-arrhythmics (medicines that keep a check on heart rhythm) help to decrease the formation of blood clots.
Managing high blood pressure helps to reduce the risk of further damage to the heart and other major organs.
Modifying lifestyle
Control of diabetes
Controlling high cholesterol and triglyceride levels
Eating a heart healthy diet of fruits, vegetables, nuts and lean meats
Getting the proper rest and exercise

While most people don’t think they are likely to have a serious condition like a heart attack, there are a few who have a higher risk than other people. People who have a family history of the disease, are overweight, have diabetes or have high blood pressure tend to suffer from silent heart attacks. Doctors advice that people with heart disease should go in for early definitive test like a coronary angiography and if required an angioplasty or by-pass surgery. Multiple aggressive counselling sessions are required for a person to get convinced for definitive management. In addition to this the fear of surgery pushes people to try out short-cuts which in turn can be more dangerous.

Read more about causes, symptoms, diagnosis and treatment of diabetes.

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