Silent heart attacks: The sneaky heart attack that can be even more deadly

Apr 07, 2024 Dr Zulfikar Bux, Features / Columnists, News

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Dr. Zulfikar Bux

Emergency Medicine Specialist

Waterfalls Magazine – When we speak about heart attacks, the thought of someone complaining of chest pains and then collapsing usually comes to mind. However, not all heart attacks occur that way and data has shown that up to 45% of heart attacks can have a typical or silent symptoms. A silent heart attack is a heart attack without the traditional symptoms; especially chest pains. Sometimes, people do not even know they are having a silent heart attack and only find out later when they go see a doctor. These have the tendency to be more dangerous as the persons affected, tend to delay accessing medical care and this increases their chance of having poorer outcomes from the heart attack. Today, I will shed some light on this silent but deadly condition.

What are symptoms of silent heart attacks?

The symptoms of a silent heart attack are not as severe as those of a regular heart attack. They can often be mistaken for other conditions. Some people, such as the elderly and diabetics, may feel no symptoms at all. The following symptoms may occur in someone who is getting a silent heart attack:

• Discomfort –The person may still feel pain, but it won’t be the unmistakable chest pain of a regular heart attack. It may feel like a discomfort in the upper abdomen, or in the upper back or jaw. It could feel like you’ve strained a muscle.
• Shortness of breath –If you are feeling short of breath or having trouble breathing doing small activities, it could be a sign of a heart attack.
• Heartburn –Mild pain in the throat or chest can be mistaken for gastric reflux, indigestion, or heartburn occurring because of a silent heart attack
• Fatigue –Physical discomfort or feeling very tired can be signs of many things. When they occur with a silent heart attack, they are often mistaken for other things. These could include poor sleep or age-related aches and pains.
• Feeling lightheaded –If you break out in a cold sweat, feel nauseated, or feel lightheaded, you could be having a silent heart attack.

If you experience one or more of these symptoms, call your doctor right away or go to the emergency room.

What causes silent heart attacks?

Silent heart attacks are caused by the same things that cause traditional heart attacks. This happens when part of the heart muscle is damaged or dies because it hasn’t received enough oxygen. This is often due to a blocked artery in the heart. However, the nerves around the heart responsible for detecting pains, may have “worn out” or were not properly activated during the heart attack and hence, pain is not detected. Risk factors for silent heart attacks are also the same for traditional heart attack and include:

• Smoking
• Diabetes
• Age – Risk increases for men older than 45 and for women older than 55 (or after menopause)
• High cholesterol
• High blood pressure
• Family history of heart attack
• Lack of exercise
• Stress
• Obesity
• Gender – Women have silent heart attacks more often than men.

How are silent heart attacks diagnosed?

Many times, silent heart attacks are found during a routine check-up. If your doctor thinks you may have had one, he or she may order imaging tests. These could include:

• An Electrocardiogram (ECG or EKG).
• Troponin levels
• Angiogram
• CT or MRI angiography
• Stress test if tolerated

These tests can show if your heart muscle has been damaged, signaling that you’ve had a heart attack.

Can silent heart attacks be prevented?

A healthy lifestyle can help prevent any kind of heart attack. This includes:

• Quitting smoking if you smoke, and avoiding secondhand smoke.
• Keeping a healthy diet that is low in fat and low in cholesterol.
• Exercising regularly.
• Managing your stress.
• Controlling your blood pressure.
• Managing your blood sugar level if you have diabetes.
• Seeing your doctor regularly for check-ups.

How are silent heart attacks treated?

Usually, silent heart attacks are found after the heart attack is over. Treatment will be similar to that of a traditional heart attack but may involve using more medicines if your heart was damaged more because of the late detection. These medicines help improve blood flow to your heart, prevent clotting, and reduce the risks of having another heart attack. Your doctor will prescribe the medicines that are right for you. If you have had a heart attack, your doctor will also talk to you about lifestyle changes. You can make these changes to prevent more heart problems.

What is life like if you survive a silent heart attack?

After you’ve had a silent heart attack, you are at higher risk of having another one. This one will likely be more severe and harmful. Also, you could have suffered damage to your heart that will make you constantly sick because your heart cannot pump blood like it could before. Your doctor will start you on medicines and will likely recommend heart-healthy lifestyle changes to help reduce your risk of getting another heart attack and make it easier to live with your damaged heart. If you have any new symptoms of heart attack or are in any doubt, visit your doctor or the emergency department right away. Early treatment is the key to surviving a heart attack and if you survive, decreases the risk of avoidable damage that may significantly hamper your quality of life.

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• attack, Dr. Zulfikar Bux, Emergency Medicine Specialist, heart, silent

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