Silent Heart Attack: Symptoms and Prevention

You May Have Had a Heart Attack Without Realizing It

However, a new study indicates that thousands of Americans may have had a heart attack and not known it. In the study, published in the American Heart Association’s journal Circulation, researchers analyzed the health records of nearly 9,500 middle-aged adults who were enrolled in a study focused on atherosclerosis, a condition that involves plaque build-up in the arteries. Researchers then looked at differences in heart attacks between several groups in the study, including men and women, and followed patients for nine years.

They found that 317 of them had silent heart attacks, while another 386 had heart attacks with obvious symptoms. By following patients for another 20 years, researchers found that silent heart attacks accounted for 45 percent of all heart attacks. These kinds of heart attacks also increased fatality rates. Those who had silent heart attacks were three times more likely to die from heart disease and were 34 percent more likely to die in general. Researchers also found another important distinction: women were more likely to die from silent heart attacks even though men were more likely to get them.

Why are silent heart attacks so deadly? Because if someone doesn’t realize they’ve had a heart attack they’re less likely to seek treatment for heart disease.

A heart attack is usually accompanied by symptoms such as chest pain, shortness of breath, upper body pain in the arms, neck or jaw and nausea or lightheadedness. However, the symptoms of a silent heart attack are barely noticeable. According to the study’s authors, these heart attacks usually are detected later when patients get an electrocardiogram (EKG) to check their heart’s electrical activity.

Signs of a Silent Heart Attack
Silent heart attacks should be treated because they indicate underlying heart disease. If you aren’t sure if you’ve had a silent heart attack, here are some signs and symptoms you should be aware of:

Fatigue: if you have unexplained tiredness, it could be a sign of cardiac issues. During a heart attack, there is reduced blood flow to the heart, which puts extra strain on the muscles and leads to fatigue. If you feel tired and have other risk factors for heart disease, such as high blood pressure, high cholesterol or diabetes, don’t hesitate to see a doctor.

Soreness in the Limbs: If you feel sore in your arms, back or chest, it could be a sign of a possible heart attack. When the arteries are blocked, blood flow to the muscles is reduced, which leads to soreness.

Heartburn: Unusual heartburn that doesn’t occur after eating may be a sign of a heart attack, especially if it is accompanied by intense chest pain.

Nausea: If you have a severely upset stomach accompanied by nausea or vomiting, it may be a symptom of a heart attack. If you haven’t eaten something to disturb your stomach, you may want to see a doctor just for peace of mind.

If you experience any of these symptoms and have other risk factors for heart disease, it’s best to get an EKG. Though silent heart attacks often go undetected, they should be treated in the same way as other heart attacks, which may reduce your risk of a future episode or potentially fatal heart attack.

But as we often say, prevention is key. Heart disease is largely preventable with healthy lifestyle choices, including regular physical activity and a balanced diet that’s low in saturated fat, salt and sugar and high in whole grains, fruits and vegetables.

A heart attack is life-altering — and potentially life-ending. So whether you’re at risk for a silent heart attack or not, take steps today to be more proactive about your health health.

What can cause a silent heart attack? Are the causes different for men than women?
The causes of silent heart attacks are the same as those that cause heart attacks with symptoms. The most common cause of a heart attack is a blockage in a blood vessel that compromises blood supply to the portion of the heart that depends on that blood vessel. However, there are many different ways that blood flow to the heart can be compromised and women may be at higher risk for some of the less common mechanisms, which include:

Spontaneous coronary artery dissection, or SCAD (when a spontaneous tear forms in the wall of a blood vessel compromising blood flow)
Coronary vasospasm (a temporary, sudden spasm of a coronary artery that can impair blood flow)
Microvascular disease (disease of small blood vessels supplying the heart)

Because less is known about less common mechanisms, these causes are harder to identify and treat. There is still so much to learn about how to improve cardiovascular care in women, and this is a focus of Mass General’s Corrigan Women’s Heart Health Program

Ways to prevent a silent heart attack:

Eating a healthy diet
Walking 45 minutes a day
Maintaining an active lifestyle
Maintaining a healthy weight
Not smoking
Drink more water, one glass before sleep
Physical Health check once a year.

Doctors can help people identify whether someone may be at higher risk for developing heart disease and can help treat some of these risk factors—like high blood pressure, high cholesterol and diabetes. Women with a history of pre-eclampsia may also be at increased risk for heart disease.

It is very important that patients who already have heart disease or have had a heart attack see a cardiologist (a doctor who specializes in diseases of the heart) regularly to care for their hearts. Patients who have had a heart attack are at particularly high risk for another heart attack, and a cardiologist can help patients reduce this risk.


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