ASK THE DOCTOR - Silent Heart Attacks

Question: I recently heard about someone who had a “silent heart attack”. What is a “silent heart attack” and how can you tell if you have had one?

Answer: A heart attack, also known as a myocardial infarction, is a condition caused by a blockage in one or more of the blood vessels that supply the heart with oxygen. Blockage of these blood vessels deprives the heart muscle of oxygen and results in permanent damage to the heart and possible death. Common symptoms of a heart attack include chest pain that may radiate into the shoulders, arms or jaw; shortness of breath, sweating, dizziness and nausea. Less common symptoms include abdominal pain, severe fatigue, or an impending feeling of doom. Anyone having these symptoms should seek emergency medical attention; unless that feeling of impending doom occurred while doing your taxes – I consider that quite normal.

Many people assume that everyone having a heart attack will have chest pain when in fact only about 50% of people having a heart attack will experience typical chest pain. Patients older than 65 as well as those with diabetes are less likely to have typical chest pain at the time of a heart attack and are more likely to report vague symptoms such as fatigue or indigestion like symptoms. Some patients have heart attacks without any symptoms, when this occurs it is referred to as a “silent heart attack”.

An electrocardiogram (EKG) is a test that can determine if a patient has had a heart attack in the past. In one study done on elderly patients, 21-68 % of patients with EKG evidence of a prior heart attack had no known prior symptoms. Many people mistakenly think of heart disease as being more common in men than women. According to the CDC; heart disease is the leading cause of death in both men and women accounting for a nearly identical 27% of all deaths in both men and women.

Patients with risk factors for heart disease such as smoking, hypertension, diabetes, elevated cholesterol, obesity or a family history of heart disease should discuss their condition with their physician to determine if they should undergo evaluation for silent heart disease. All patients should seek emergency attention whenever they experience chest pain or any of the other warning symptoms of a heart attack.

If you would like to submit a question please contact Jennifer Trebler at jtrebler@ramonavna.org.