Heart Attack? You May not know it!

The nation’s longest-running heart study suggests that about one heart attack in four produces no symptoms – or at least none that the victim associates with a heart problem.

These so-called “silent heart attacks,” however, are only the most extreme case of a still more prevalent condition called “silent ischemia” – a chronic shortage of oxygen – and nutrient-bearing blood to a portion of the heart. Both conditions put their victims at significant risk.
Silent Heart Attacks

Silent Ischemia

The cause of ischemia, silent or otherwise, is almost always atherosclerosis – the progressive narrowing of the heart’s arteries from accumulations of cholesterol plaque. In most instances, this reduction in blood supply generates a protest from the heart – the crushing pain called angina. But in perhaps 25 to 30 percent of heart attack victims, there were no previous symptoms of these gradually developing blockages. The Framingham Heart Study, which followed 4,000 Massachusetts men for more than 40 years, found that 25 percent of their subjects’ heart attacks go unnoticed until their annual EKGs detect their after-effects.

The absence of pain, however, doesn’t mean an absence of heart damage. The heart has a built-in reserve capacity, allowing it to suffer a certain amount of scarring and weakening from a heart attack and continue to meet the body’s needs. But further ischemia or another heart attack, even a mild to moderate one, may prove fatal because that reserve capacity is no longer there. Even those who survive another heart attack are at increased risk of becoming cardiac cripples, disabled by congestive heart failure or arrhythmias heartbeat irregularities.

There is no way of predicting absolutely who is a candidate for silent ischemia, but statistically, the greater the number of risk factors for coronary artery disease that you have, the more likely you are to be a candidate. Those risk factors include some you can’t control – your age, sex and genetic predisposition to atherosclerosis – and those you can influence, like diabetes, high blood pressure, high blood cholesterol, smoking, lack of exercise and obesity.

Silent Heart Attack

As a rule of thumb, I would urge you to undergo a screening for silent ischemia if you have any three of these factors working against you – a man over age 50 who smokes, or a post-menopausal woman with a ten-year history of diabetes and chronic unfavorable blood cholesterol levels, for instance.

The screening for undetected ischemia is a medical history and physical examination and a cardiac stress test – a workout on a treadmill while your heart function is monitored.

It’s a simple, painless and inexpensive way to learn whether the beating of your heart is accompanied by the inaudible ticking of an atherosclerosis time bomb that could kill you.

Disclaimer: I am not a doctor and am simply passing along information I found useful. You should verify this information.

By William R. Condos, Jr., M.D., Medical Director, Cardiovascular Institute of the South/Lake Charles

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3 replies
  1. Dixie McCormick says:

    Patty McRoberts…………..Print the comment you just made. Take it to your doctor and when she comes in the room have her read it. If you still don’t get satisfaction tell her you must then change doctors to one that will listen to you. Don’t give up girl, you are worthy of a happy healthy life.

  2. andreag says:

    Patty- I hope you are feeling better, perhaps you want to try a new doctor? In the mean time, know that you are not alone! Anxiety can cause all of the symptoms you listed, but you should insist on getting checked for peace of mind. As for the depression- a study showed that people who smoke tend to suffer from clinical depression, and that the smoking acts as an anti-depressant for them. It’s no wonder you feel this way after quitting (good for you though!) Maybe see a psychiatrist, or try 5-HTP. You can get it at a health food store- it’s nature’s antidepressant. Best of luck to you!!

  3. patty mcroberts says:

    at my age.. 55 in this April.. my doctor is NOT being forthcoming and only one complaint per visit.. i have suffer suicidal thoughts.. and need to see a real psychiatrist to analyze what i need.. still waiting after 5 months.. all i do is cry every day at home.. at the same time i quit smoking 7 months ago had me gained 30 lbs up to 165 lbs should be around 145 to 150 be okay.

    I keep having feelings of doom due to my mental sadness combined to chest uncomfortable, shortness of breath.. unable to breath at night gasping for air .. tired all the time.. gone to gym.. but still hard..

    I am not able to find another doctor to take me asap as they are on a freeze which is in Calgary, ab. .

    i tried to tell my doctor but she rushes me.. i don’t know what to say to her how i felt of all the combined problems. I wish someone was there to speak on my behalf as i have trouble groping for words i need to make her listen.. heart test. she wont do it for me.. i go home crying.

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