Silent Heart Attack
When There Are No Symptoms

silent heart attack

Sensation of Pulled Muscle May Indicate Silent Heart Attack

Silent Heart Attack

Contents

Surely I'd Know If I Had A Heart Attack?
So What Is A Silent Heart Attack?
What Is The Cause?
Is There Any Way Of Recognizing It?
How Is It Treated?
Why Are There No Obvious Symptoms?
What Are The Risk Factors?


Back To Main Guide
Heart Attacks in Women

Surely I'd Know If I Had A Heart Attack?

Not necessarily. It is estimated that 3 to 4 million Americans have heart attacks every year without knowing it. Sounds pretty hard to believe but it is true. What they in fact experience is a 'silent' heart attack which does not cause typical heart attack symptoms. A silent heart attack typically causes no pain or else pain is so mild it is mistaken for a bout of indigestion or stress. Yet, these types of heart attacks are not less serious than the regular type. They have the same cause and consequence as a regular heart attack and carry the same life expectancy. The only difference is, you just do not know you had it. Very often the first sign a person has is during a routine health screening when it is picked up on an exercise stress test or electrocardiogram ECG (perhaps only years later).

So What Is A Silent Heart Attack?

It is a silent ischemia. An ischemia is when blood flow is restricted. Blood can be restricted in any part of the body, but when it happens to the heart it is called a cardiac ischemia. If a cardiac ischemia lasts too long it can cause a heart attack. The part of the heart muscle which is affected dies and can no longer recover. This resulting damage is one of the leading causes of congestive heart failure - where the heart no longer works as efficiently as it used to. If enough muscle is damaged, the person can die. Most people who have regular episodes of angina attacks or chest pain are likely to experience episodes of silent ischemia.

What Is The Cause?

The cause of silent ischemia is the same as other causes of heart attacks. Both are caused by a blood clot (thrombus) blocking one of the coronary arteries, a classic outcome of coronary heart disease (CHD). The longer the blockage is in place, the greater the loss of heart muscle and the greater the risk of death.

Is There Any Way Of Recognizing It?

With silent heart attacks you do not get the typical crushing chest pain most people associate with heart attacks. Some people experience nothing while others can get vague symptoms such as generally feeling unwell for a few hours or have a bit of a jaw ache which they put down to indigestion. However, many find afterwards that everyday tasks suddenly become more difficult and make them breathless more easily. The following is a typical example: Jane is a 53 year old woman, who is relatively fit and does not smoke. She suddenly finds herself short of breath when doing ordinary tasks like taking the bins out or carrying her shopping in from the car. Although she initially puts the symptoms down to a virus or flu, she cannot shake the breathlessness, even weeks later. It is only because she knows her risk factors for heart disease are high (her mother had a heart attack at 55) that she visits a chest pain clinic and asks to be checked out. The center carries out some simple heart attack tests using an ECG. This test highlights a dead area of muscle tissue on her heart which indicates a heart attack has occurred. She is also given a blood test to check for cardiac enzymes which are proteins (creatine kinase and troponin) that are released into the bloodstream when the heart is damaged. Jane is asked to think back to when it may have occurred. She remembers playing tennis with her friends and feeling a muscle pull in the chest which she put down to over-exertion. This is probably when the heart attack occurred. She may then be scheduled for a coronary angiography where flexible tubes are inserted into the arteries to check for blockages (image). This provides a more exact diagnosis.

Summary: Tell-Tale Signs


Although there may be no symptoms, experts have identified some signs that can be easily overlooked but could signal something is wrong:

• Unexplained breathlessness.
• Slight feeling of chest discomfort — like a pulled muscle.
• Generally feeling unwell or nauseous for a few hours.
• Indigestion.

How Is It Treated?

Treatment for silent ischemia is the same as a regular heart attack treatment. The aim is restore blood flow through the coronary arteries which have become blocked by the buildup of fatty deposits (a process called atherosclerosis). Doctors will also recommend lifestyle changes and drugs such as beta blockers or anticoagulant medications. The patient may be asked to wear a Holter Monitor for a 24-48 hour period to check for any more episodes of silent ischemia in that period. Ultimately surgery such as coronary angioplasty (image) followed by cardiac rehabilitation may be required to reach the final goal.

Why Are There No Obvious Symptoms?

Considering that a silent heart attack can be just as deadly as a heart attack with classic signs of chest pain, this is a valid question. Doctors are not sure how someone can have a heart attack without it hurting. It might be that the person has a higher pain threshold than other people or it might be that there is nerve damage around the heart that prevents the sensation of pain being transmitted. According to studies diabetics are at particularly high risk because high blood sugar levels can damage nerve endings.

What Are The Risk Factors?

1. People with regular episodes of angina attacks or chest pain are more at risk.
2. If you have a family history of premature CHD (that is a parent or sibling who was diagnosed with the condition before 55) your risks are higher.
3. If you have other heart attack risk factors such as high cholesterol, being overweight or smoking.

If you do have cardiac risk factors (including angina), it is important to have regular health screenings that include an ECG or stress test. Read more about heart attack prevention.

  Related Articles on Myocardial Infarction

For more on heart issues, see the following:

Coronary Heart Disease in Women
Heart Attack Questions
Automated External Defibrillator / Home Defibrillator

Back to Homepage: Womens Health Advice


WOMENS HEALTH ADVICE: ABOUT A HEART ATTACK
Sources
Please Note: Information provided on this site is no substitute for professional medical help. See Disclaimer.
Copyright. All rights reserved.