By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine
We often associate having a heart attack with chest pains. Well this is not always the case with heart attacks. There are times when persons do have a heart attack but it’s silent. Recent research suggests that nearly half of all heart attacks are silent heart attacks. A silent heart attack is a heart attack without the traditional symptoms. You often don’t know you are having a silent heart attack. Many people don’t find out until weeks or months later when they visit their doctor for other symptoms or symptoms related to a complication from their silent heart attack.
WHAT ARE SOME SYMPTOMS OF A SILENT HEART ATTACK?
The symptoms of a silent heart attack are not as severe as those for a regular heart attack. They can often be mistaken for other conditions. Some people feel no symptoms at all. Pay attention when you feel any of the following:
• Discomfort – You may still feel pain, but it won’t be the unmistakable chest pain of a regular heart attack. You may feel discomfort in the upper abdomen, in your back, or in your jaw. It could feel like you’ve strained a muscle.
• Shortness of breath – If you are feeling short of breath or having trouble breathing doing small activities, it could be a sign of a heart attack.
• Heartburn – Mild pain in the throat or chest can be mistaken for gastric reflux, indigestion, or heartburn.
• Fatigue – Physical discomfort or feeling very tired can be signs of many things. When they happen with a silent heart attack, they are often mistaken for other things. These could include poor sleep or age-related aches and pains.
• Feeling lightheaded – If you break out in a cold sweat, feel nauseated, or feel lightheaded, you could be having a silent heart attack.
WHAT CAUSES SILENT HEART ATTACKS?
Silent heart attacks are caused by the same things that cause traditional heart attacks. This happens when part of the heart muscle is damaged or dies because it hasn’t received enough oxygen. This is often due to a blocked artery in the heart. Risk factors for silent heart attacks are also the same. They include:
• age – Risk increases for men older than 45 and for women older than 55 (or after menopause)
• high cholesterol
• high blood pressure
• family history of heart attack
• lack of exercise
• gender – Women have silent heart attacks more often than men.
HOW ARE SILENT HEART ATTACKS DIAGNOSED?
Many times, silent heart attacks are found during a routine check-up. If your doctor thinks you may have had one, he or she may order imaging tests. These could include an electrocardiogram (ECG or EKG) or an angiogram. These tests can show if your heart muscle has been damaged, signaling that you’ve had a heart attack. If you’ve gone to the emergency room with silent heart attack symptoms, the doctor may order blood tests.
Can silent heart attacks be prevented or avoided?
A healthy lifestyle can help prevent any kind of heart attack. This includes:
• Quitting smoking if you smoke, and avoiding secondhand smoke.
• Keeping a healthy diet that is low in fat and low in cholesterol.
• Exercising regularly.
• Managing your stress.
• Controlling your blood pressure.
• Managing your blood sugar level if you have diabetes.
• Seeing your doctor regularly for check-ups.
HOW IS A SILENT HEART ATTACK TREATED?
Normally, silent heart attacks are found long after the heart attack is over. Treatment will mostly involve taking medicines. These medicines help improve blood flow to your heart, prevent clotting, and reduce the risks of having another heart attack. Your doctor will prescribe the medicines that are right for you. If you have had a heart attack, your doctor will also talk to you about lifestyle changes. You can make these changes to prevent more heart problems.
LIVING WITH SILENT HEART ATTACKS
After you’ve had a silent heart attack, you are at higher risk of having another one. This one will likely be more severe and harmful. Your doctor will likely recommend heart-healthy lifestyle changes to help reduce your risk. Symptoms during a second heart attack may be different than the first one. If you have any new symptoms of heart attack or are in any doubt, do not hesitate to visit your doctor or an emergency room. Early treatment is the key to surviving a heart attack.
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