Silent heart attack (silent ischemia): Symptoms, causes, and treatments

By: Dr. Victor Marchione | Heart Health | Sunday, April 09, 2017 - 05:00 AM

Silent heart attack (silent ischemia): Symptoms, causes, and treatmentsSilent heart attack (silent ischemia) has been found to leave scars on the heart. A silent heart attack is a heart attack with minimal, if any, symptoms. For this reason, it is difficult to know when you are experiencing a heart attack, which can lead to further complications an even death. Some reports of silent heart attack suggest it is often confused with indigestion or even a bad flu.

Having a silent heart attack puts a person at greater risk of experiencing a future heart attack. The only way to determine if you are experiencing a silent heart attack is through an electrocardiogram, echocardiogram, or another imaging of the heart.

Risk factors of a silent heart attack are similar to those of a normal heart attack, which include:

  • Smoking
  • Family history of heart disease
  • Age
  • High cholesterol
  • High blood pressure
  • Diabetes
  • Lack of exercise
  • Being overweight

Is a silent heart attack dangerous?

When we imagine getting a heart attack, most of the time we picture ourselves in agonizing pain while we clutch onto our chest as we keel over. We think that it will be an obvious show of distress that anybody will recognize, sending help as soon as they see what has happened to us. Sadly, getting a silent heart attack may not be so dramatic, as it can have a more subdued presentation and is deemed a “silent heart attack”.

Just like the name implies, experiencing a silent heart attack means that expected symptoms like shortness of breath, chest pain, and cold sweats are not present. You may brush it off as some minor heartburn or some other chest discomfort, not realizing that your cardiac muscles are becoming damaged.
Symptoms of silent heart attacks are minimal or none at all, but still have all the negative consequences of having a more recognizable myocardial infarction. Blood flow to a section of the heart is temporarily blocked and can cause scarring and damage. This can lead individuals to neglect to go to see a doctor as they assume nothing is wrong.

New research suggests that many Americans suffer “silent” heart attacks

New research suggests that many Americans suffer from silent heart attacks, which leave scars on the heart. Dr. Stacey Rosen from the Katz Institute for Women’s Health said, “We know that risk factors for heart disease – the number one killer of American men and women – are predominantly modifiable, so this finding gives further support to the notion that early identification and management of these risks is critical.”

The research teamed analyzed images of 1,800 hearts from a diverse group of individuals who did not have heart disease.

After 10 years, the participants underwent heart imaging again, which revealed that eight percent of the individuals had scars on their heart, signalling that they experienced a heart attack.

Men were more likely to experience silent heart attacks compared to women, and other factors that contributed to heart scarring were smoking, being overweight, calcium-deposits and the use of blood pressure medication.

The researchers suggest that EKG performed in doctor’s offices can only detect small percentages of silent heart attacks and suggest that healthy lifestyle habits are necessary to reduce the risk of cardiovascular events.

The findings were published in the Journal of the American Medical Association.

Symptoms of silent heart attack

A silent heart attack occurs when oxygen to the heart becomes reduced. There are many reasons why oxygen may not reach the heart, including an obstruction in the arteries due to plaque build-up. The risk factors listed above can also contribute to the onset of a silent or normal heart attack.

Symptoms, if any, of a silent heart attack, include:

  • Chest pain
  • Indigestion or heartburn
  • Dizziness
  • Weakness
  • Nausea and vomiting
  • Profuse sweating
  • Sudden fatigue
  • Sudden loss of consciousness
  • Shortness of breath
  • Throat, neck, or jaw discomfort
  • The overwhelming feeling that something is wrong

Causes of a silent heart attack

A slient heart attack occurs when blood flow is blocked in the coronary arteries by the buildup of plaque, with some studies suggesting that these types of heart attacks are more common in women than men. Making a diagnosis of a silent heart attack can be difficult, as doctors are trained to look for the most common symptoms and not just do every single test for minor symptoms whenever they arise. But suspicion should be raised if the patient in question has all the risk factors as those who get more recognizable heart attacks. These risk factors include:

  • High blood pressure
  • High cholesterol
  • Obesity
  • Older age
  • History of smoking
  • Family history of heart disease
  • Prevent a silent heart attack
  • Tips to prevent a silent heart attack include:
  • Stop smoking
  • Limit alcohol consumption
  • Lower blood pressure
  • Manage other health conditions like diabetes
  • Lose weight
  • Eat healthy
  • Exercise
  • Reduce bad cholesterol

Treatment for silent heart attack

A heart attack, silent or normal, is a medical emergency and requires immediate attention from a doctor. Get yourself to a hospital as quickly as possible at the first sign of a heart attack.

At the hospital, you will be put under oxygen therapy to prevent your heart from overworking itself. Medications like aspirin, morphine, and nitroglycerin can be administered in order to relieve pain, open up blood vessels and lessen the detrimental effects of a heart attack.

While in the hospital, you will be monitored to ensure no long-term damage has been done. In recovery, the doctor may prescribe daily medications or offer recommendations about lifestyle changes that are necessary to keep your heart healthy and prevent any future occurrences. The following is what you can expect when being treated in the hospital:

  • Will be given oxygen to allow the heart to work more efficiently
  • You will be hooked up to a cardiac monitor to keep an eye on your status
  • You will be given aspirin, as it help thin the blood decreasing the changes clot formation
  • A venoclysis (vein access for fluid infusion) would be started right away as it will be easier to access the vein for intravenous (IV) medications
  • You will be given medications such as nitroglycerin and morphine to relieve any chest pain
  • You will be continually watched and looked after to avoid any potential fatal complication.

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Related Reading:

Types of heart attack: STEMI, NSTEMI, and silent heart attack

Silent heart attack risk higher among those with higher pain tolerance

Sources:

http://www.rd.com/health/conditions/silent-signs-heart-attack/
http://byebyedoctor.com/silent-heart-attack/
https://www.goredforwomen.org/about-heart-disease/facts_about_heart_disease_in_women-sub-category/silent-heart-attack-symptoms-risks/
http://www.health.harvard.edu/heart-health/the-danger-of-silent-heart-attacks

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