Know the Signs of a Silent Heart Attack

SPRINGFIELD — Are you tired? Do you have indigestion? Do you think you may have pulled a muscle in your upper back, chest, or arms? Don’t ignore these subtle symptoms. You could be having a silent heart attack.

According to the American Heart Assoc., silent heart attacks account for around 170,000 of the estimated 805,000 annual heart attacks. All too common, silent heart attacks are often overlooked.

“Silent heart attack, or myocardial ischemia, is a condition of reduced oxygen-rich blood flow to the heart without symptoms of chest discomfort or other equivalent symptoms such as difficulty breathing, nausea, and sweating,” said Dr. Kelly M. Wanamaker, cardiac surgeon at Baystate Health and assistant professor of Cardiothoracic Surgery at UMass Chan Medical School – Baystate. “This is accompanied by changes on studies such as an electrocardiogram that looks for electrical changes or echocardiogram, an ultrasound of the heart that looks at function.”

Wanamaker said it’s imperative to know and understand the risk factors for a silent heart attack, which are the same as those for a heart attack with symptoms. Risk factors include diabetes, age, excess weight, family history, high blood pressure, high cholesterol, lack of exercise, obstructive sleep apnea, tobacco use, and prior heart attack.

“It has been reported that patients with silent heart attacks have a greater chance of developing new coronary events than those without silent ischemia; therefore, they need an aggressive diagnostic and therapeutic approach,” she added. “The risk for those with silent heart attacks includes an increase in complications or death since patients often do not seek medical attention in a timely fashion.”

Many people don’t realize they’re having a silent heart attack because they’re not having obvious symptoms. However, Wanamaker said some can be medically managed with beta blockers, which help to decrease the heart’s demand by lowering the heart rate and blood pressure; aspirin to make the platelets less sticky and allow blood to flow freely; and lipid-lowering therapies.

February is American Heart Month, a time to shine a spotlight on heart disease, the number-one killer of Americans, and a time when all people can focus on their cardiovascular health and address their risk factors for the disease.