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HowToPreventHeartDisease.com |
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Is Silent Heart Attack Dangerous?
Heart attack, also known as myocardial infarction, happens when an atherosclerotic plaque in one of the coronary arteries ruptures. The rupture triggers a blood clot to form in the artery producing an acute blockage. Ischemia (a restriction in blood supply to tissues that causes a shortage of oxygen) may immediately occur in the heart muscle affected. This typically leads to chest pain (angina) or other alarming symptoms. If the blockage is not cleared within a few hours, the ischemic heart muscle dies. Victims of heart attack would have common symptoms like extreme chest pain and pressure; stabbing pain in the arm, neck, or jaw; sudden shortness of breath; sweating, and dizziness. Nevertheless, one can have a heart attack and not even know it. A silent heart attack, known as a silent myocardial infarction (SMI), account for 45 percent of heart attacks and strike men more than women. It is called silent because when it happens, either there are no noticeable symptoms, or the symptoms lack the intensity of a classic heart attack. Does it mean that a SMI is less serious as the classic heart attack? In reality, a person who has a SMI is at a greater risk of having another heart attack that could be fatal. Moreover, having another heart attack also raises the risk of complication like heart failure. Some studies conducted in Iceland and Finland have helped to find out how often SMI occurs and the long-term effect linked to them. In one study conducted in Iceland, 935 men and women initially aged 67 to 93 were enrolled and followed for up to 13.3 years. At the outset of the study, each participant underwent a noninvasive test called cardiac magnetic resonance imaging that can most reliably show whether a SMI had already occurred. Initially, 17 percent were found to have had an SMI and 10 percent had had a recognized attack.
After the first 3 years of follow-up, there was no difference in death rates between those who had an SMI and those who did not. The death rate in both groups was 3 percent, significantly lower than the 9 percent among those who had a recognized heart attack. By 10 years, half the participants with SMI had died, and the death rate was similar to those with a history of a recognized heart attack. In addition to death, there was also a higher risk of developing congestive heart failure. Half of those who develop congestive heart failure die within 5 years of diagnosis. The findings were published November 2018 in ‘JAMA Cardiology’. In another study, published in ‘JAMA Cardiology’ in July 2019, involved autopsy findings among 5,869 men and women, average age 65, who experiment sudden cardiac death in Northern Finland. Evidence of an SMI was found in 1,322 individuals who had no prior history of coronary artery disease. Moreover, those who had sudden cardiac death during physical activity were more frequently found to have enlarged hearts. An enlarged heart by itself is already a risk factor for sudden cardiac death, and when combined with heart muscle scars from a prior SMI, the prognosis is worse. Apparently, individuals with SMI were unaware of their disease and presumably did not limit their physical exertion when unrecognized symptoms occurred. The researchers suggested that a previously scarred heart can trigger abnormal heart rhythms and result in sudden death during exercise. People who have any risk factors for heart attack, particularly diabetes, should be more vigilant. Diabetics are more prone to having a SMI as the poor circulation and high sugar in their blood damages their nerve cells so that they do not experience pain the same way as someone with no diabetes. SMI often leaves scarring and damage to the heart. And because people who have a SMI do not obtain immediate medical treatment, they have a 3 times higher risk of dying from coronary artery disease. While SMI can be as dangerous as the classic heart attack, if anyone at elevated cardiac risk can adhere to a heart-healthy lifestyle, the incidence of heart disease would be reduced by 80 percent, even without medication, according to some health experts. Date: January 02, 2020
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