‘Silent heart attack can be subtle, even asymptomatic’

Recently, there have been news coming of persons and celebrities, especially young guys in their 30s or 40s, dying suddenly. Unfortunately, while some died at gym, others died while doing other physical activities and some in their sleep. Many inquisitive minds, both old and young, have questioned me regarding this.

Regrettably, still not most of the people know this fact that heart diseases kill more people in a year than all cancer deaths added together. Yet, it is taken with levity in general public perception.

A silent heart attack, also known as a silent myocardial infarction (SMI), is a heart attack that occurs without noticeable symptoms or with symptoms that are mild enough to be mistaken for other conditions. Unlike the typical heart attack depicted in movies, where a person clutches his chest in agony, a silent heart attack can be subtle and even asymptomatic. Indeed, it’s a heart attack without obvious symptoms or with those that are mistaken for something else — like indigestion, fatigue or muscle pain.

Tell-tale signs are usually very subtle and often overlooked and dismissed as benign by many. We consider a mild chest discomfort or feeling of chest pressure to be due to bad night posture while symptoms like fatigue and weakness are attributed to late night overwork, even recurring nausea or indigestion, which can be a warning sign of heart attack.

Pain in the jaw is designated as dental agony. Neck or upper back pains are considered as cervical pain, which actually can be due to an impending heart attack. Shortness of breath is attributed to lack of exercise and our mind blames it on sedentary lifestyle or age factor or overweight, whichever excuse looks suitable to us when we are unable to find the plausible cause for it. These are all warning signs of a silent heart attack, which are wilfully ignored till it becomes a life-threatening event.

What we need to do is to be even more careful about these symptoms, especially in people who have diabetes or older adults, particularly women, patients with complaints of high blood pressure, high cholesterol or those who have a family history of heart disease. Even individuals with obstructive sleep apnea or inflammatory condition or with stress disorders are at high risk of having silent heart attacks.

Young people who are obese or are smokers or are taking recreational drugs or have drug addictions are particularly prone to it. Many young athletes who apparently appear fit are reported to have suddenly collapsed on field are found to be having hypertrophic obstructive cardiomyopathy or underlying genetic arrhythmic disorders on further investigation.

Many youngsters who aspire to have perfect body resort to various body enhancing drugs or those in pursuit of rapid weight loss programmes have unfortunately lost their lives by resorting to unscientific methods or following social influencers, who lack the required medical knowledge.

It is quite disheartening for doctors as they find it more challenging to diagnose it as there is very little acceptance and rather great resistance to even considering the hard facts. To all intents and purposes, many find it totally unnecessary and rather wastage of time and money to subject themselves for medical evaluation. Many resign to fate, fearing that their suspicions might turn out to be true and doctor will put them on lifelong medications, which seem to be like a compulsion or burden that they feel they have to bear for the rest of life.

However, for a sizeable section of people who are health conscious, they are advised to undergo regular checkups. By doing tests like electrocardiogram (ECG), echocardiograms or stress tests and blood tests for cardiac enzymes, along with other routine blood investigations, we can surely assess things to a large extent.

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