A silent heart attack, also known as silent ischemia or silent myocardial infarction, occurs without noticeable or recognizable symptoms. Unlike typical heart attacks, which often involve crushing chest pain and shortness of breath, silent heart attacks may present with subtle or nonspecific symptoms such as fatigue, indigestion, or muscle soreness in the chest or upper back. These attacks can be just as dangerous as traditional heart attacks, leading to long-term damage to the heart muscle and increasing the risk of future complications.

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Prevalence

Silent heart attacks are more common than many realize. In India, they account for approximately 45% of all heart attacks. Men are twice as likely to experience them compared to women, although women may also be at higher risk due to misdiagnosis or dismissal of symptoms as stress-related. Older adults and individuals with diabetes or high blood pressure are particularly susceptible

Who’s at Risk?

• People with diabetes, due to diabetic neuropathy, may not feel pain normally
• Elderly individuals
• Women, who often experience atypical symptoms
• Smokers
• Those with hypertension, high cholesterol, or a family history of heart disease

Causes

Similar to a normal heart attack, silent heart attacks are caused by a blockage in the coronary arteries due to plaque buildup. This restricts blood flow to the heart muscle, depriving it of oxygen. Common risk factors include:

• High cholesterol levels
• Hypertension (high blood pressure)
• Diabetes
• Obesity
• Smoking
• Sedentary lifestyle
• Family history of heart disease
• Advancing age
• Stress and unhealthy dietary habits.

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Diagnosis

Diagnosing silent heart attacks is challenging due to the absence of prominent symptoms. They are often detected incidentally during routine check-ups or evaluations for unrelated conditions. Diagnostic methods include:

• Electrocardiogram (ECG): Detects abnormal electrical activity in the heart.
• Echocardiogram: Ultrasound imaging to assess damage to the heart muscle.
• Cardiac MRI or CT scans: Provide detailed images of the heart.
• Blood tests: Measure biomarkers indicating a recent cardiac event.

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Prevention and Awareness

Preventing silent heart attacks involves managing risk factors through:

• Routine health screenings for cholesterol, blood pressure, and diabetes.
• Maintaining a balanced diet and regular exercise.
• Avoiding tobacco products.
• Monitoring for subtle symptoms like fatigue or indigestion.

Therefore, if someone has risk factors or symptoms, they should not ignore these symptoms. Early detection can be lifesaving.

Citations:
[1] https://asianheartinstitute.org/blog/silent-heart-attack-symptoms-causes-and-prevention/
[2] https://www.heart.org/en/news/2021/06/23/silent-heart-attacks-all-too-common-and-often-overlooked
[3] https://sahyadrihospital.com/blog/how-common-are-silent-heart-attacks/
[4] https://www.medicalnewstoday.com/articles/silent-heart-attack
[5] https://healthcare.utah.edu/healthfeed/2024/08/quiet-threat-understanding-silent-heart-attacks