“Silent” heart attack! Silent Killer

GUEST COLUMN: Dr. N Prabhudev

Bengaluru, Dec. 13: “Silent” heart attack!Heart attack you never knew you suffered!
Unrecognized MI constitutes an underappreciated public health problem.
Silent heart attacks occur more commonly in men than in women; however, silent heart attacks are more fatal for women.

•Every 40 seconds someone has a Heart attack

• 10 Million People have heart attack every year- a third of whom die before reaching hospital often because they don’t seek help in time.

• Three of the four attacks are first Heart attacks

• Two in five is a silent Heart Attack!

About half of all heart attacks are mistaken for less serious problems and can increase your risk of death from coronary artery disease. Bollywood or Hollywood heart attacks – The image of a man clutching his chest before hitting the ground in pain is quite possibly the quintessential image of someone having a heart attack. That’s more of a theatrical version of a heart attack than a realistic one.

A silent heart attack, known as a silent myocardial infarction, accounts for 45% of heart attacks. They are described as “silent” because when they occur, their symptoms lack the intensity of a classic heart attack, such as extreme chest pain and pressure; stabbing pain in the arm, neck, or jaw; sudden shortness of breath; sweating, and dizziness. Silent heart attacks have the same life-altering—or ending—capabilities as a regular heart attack. Diabetics, in particular, are frequently affected by silent heart attacks due to the presence of neuropathy.

Symptoms of SMI or Silent Heart attack
• lightheadedness
• Short of breath
• Indigestion or Heart burn
• flu or influenza like body aches
• Sprained a muscle in their chest or their upper back.
• Mild discomfort in the chest,
• Pain in the jaw or the upper back or arms
• Prolonged and excessive fatigue that is unexplained.
• cold sweats

What increases your risk of having a silent heart attack?
Being obese
Smoking with Diabetes
Sedentary life style
High blood pressure
A high cholesterol level
Eating foods that are high in salt,
A high blood sugars

What triggers a silent heart attack?
• A person with a history of risk factors on exposure to cold weather
• Sudden un-accustomed exercise
When you feel symptoms — even if you’re unsure if they are from a heart attack — it’s best to get Medical care quickly. Let the doctor decide if there is a heart attack or not! Don’t disregard subtle symptoms.
Nearly every second heart attack is silent in nature and can only be detected by an electrocardiogram –ECG which will show the characteristic markings of a prior heart attack. Magnetic resonance imaging (MRI) is more effective than electrocardiography (ECG) at identifying “silent” heart attacks, also known as unrecognized myocardial infarctions.
Treatment is most effective if started within one hour of the onset of symptoms but on average people wait 90 minutes because they want to see if the pain will go away. Eighty-five percent of heart damage happens in the first two hours following a heart attack.
Preventive measures
Regular periodic screening in patients with risk factors, Avoid smoking, Control- Diabetes and BP, Regular physical exercise, avoid obesity, control cholesterol, avoid alcohol!

Silent heart attacks may raise risk of death in the long term.
Investigate with cardiac catheterization wherever needed, if necessary one may have to go for Angioplasty and stent placement or if multiple arteries are involved CABG may have to be considered. My message is to go for health screening and identify your risks, keep your risk factors under control, and adopt a healthy lifestyle with healthy eating and exercise. This will minimize your risk for developing a heart attack for years to come.
People who have had a silent heart attack may be at greater risk of this if the damage to the heart is significant and has been left untreated. For these individuals, a second heart attack could very well be fatal. People diagnosed with a silent heart attack tend to have a somewhat worse long-term prognosis than those with a classic heart attack.

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