Danger of ‘silent’ heart attacks is lack of recognition

Ultrasound scan, file picture.

Ultrasound scan, file picture.

There is no doubt that heart disease is a killer. In fact, according to the World Health Organization, it is the biggest killer – and is responsible for nearly half the deaths (48.6%) of all the 10 leading causes.

Some years ago I had a heart attack although there were no obvious signs at the time. It was diagnosed later as a silent attack – the type that people suffer and do not realise they have had.

This week I learned that, as a result of new research, experts now say that 45% of people who have heart attacks suffered the ‘silent’ variety, where patients believe they have strained a muscle or have indigestion. Sometimes these may be associated with unexplained fatigue and discomfort in the jaw, upper back or arms.

Silent heart attacks can cause just as much damage as heart attacks which are instantly recognised. But as silent attacks do not come with the usual symptoms of chest or arm pain, patients do not recognise the danger and tend not to seek treatment which can help prevent another.

The research, published in the American Heart Association journal Circulation, looked at the records of 9,500 middle-aged men and women between 1987 and 2013. Nine years into the study 7.4% of the volunteers had had heart attacks; 317 were silent, while 386 noticed symptoms immediately.

Lead researcher, Dr Elsayed Soliman of the Wake Forest Baptist Medical centre, North Carolina, found the silent attacks are more common in men, but are more dangerous for women who are more likely to die from this type of attack.

Patients who have suffered a silent heart attack should be treated as if they had suffered the usual symptoms, according to Dr Soliman.

As a silent heart attack happens without the usual symptoms, such as chest pain and overwhelming anxiety, shortness of breath may be the only warning sign. But even that is not a great indicator when, like me, you already have multiple sclerosis which includes bouts of fatigue and breathlessness.

However, in 2010 even greater fatigue than usual and more frequent shortness of breath did convince me to see my GP. He diagnosed atrial fibrillation (irregular heartbeat) and referred me to a cardiologist.

There, two ultrasound scans quickly followed. At first, they thought there was a clot in the heart but doubts about that were raised by the second ultrasound – so an MRI was requested. This showed conclusively that the supposed clot was, in fact, a scar from a previous silent heart attack.

The usual ‘go to’ steps for anyone with a heart condition didn’t really apply in my case: having never smoked, being on the heavier side of ‘acceptable’ and cholesterol and blood pressure both testing as normal. Taking more exercise, however, was severely hampered by mobility problems caused by MS.

Today, even though my heart attack was silent and unknown by me, heart-related medications outnumber those taken for anything else.

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