Posted on Feb 21, 2020, 4 p.m.
February is American Heart Month, in light of this it may be time to provide a little reminder of the symptoms of the lesser known silent heart attack, symptoms that cardiologists suggest should not be ignored including indigestion, shortness of breath, and sudden fatigue which could all be signs of heart trouble.
In real life having a heart attack is nothing like it is portrayed to be in the movies. Although some of those incidents are possible, not all heart attacks will follow that pattern. Some people may not even be aware that they have had a heart attack until they have had a subsequent one that sends them to the hospital.
“The definition of ‘silent heart attack’ is that someone has had heart damage but didn’t experience enough classic symptoms to go into the ER,” says Robert Greenfield, M.D., cardiologist and medical director of Non-Invasive Cardiology and Cardiac Rehabilitation at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, Calif. “Often, we only find out they happened after they’ve had a second heart attack and that first, silent one shows up in their test results.”
Silent heart attacks can even happen while you are sleeping without waking you up, you may even be jarred awake at the end of the heart attack and be thinking it was due to snoring or a bad dream. The same risk factors that apply to a silent heart attack are the same ones for a typical heart attack such as high cholesterol, smoking, diabetes, stress, illicit substance use, and having a strong family history of heart attack.
“Diabetic patients may be at particularly high risk for silent heart attack because chronic diabetes causes degeneration of the heart’s autonomic nerves, which typically alert one to a heart attack,” says Olujimi Ajijola, M.D., Ph.D., a cardiologist at Ronald Reagan UCLA Medical Center. “Also, women may have a higher risk of not recognizing the signs of a problem because they tend to have atypical symptoms for heart attacks, like abdominal pain, jaw discomfort, or just feeling generally unwell.”
While silent heart attacks are more difficult and less cinematic than a more major heart attack there still are some subtle signs that your heart may be stressed which may be warning you of a possible event.
Both the lungs and heart work together to make sure the blood has enough oxygen at all time, when something is wrong with the cardiovascular system breathing is typically affected immediately. You may feel winded walking across the room or for no reason at all, this can be confused with a panic attack, but if deep breathing doesn’t reset to allow you to get more air you should go to get checked out. Even if it is not a heart attack it is still worth investigating.
When there is a problem the heart will try to correct by pumping faster, there may also be a change in the way the upper chambers of the heartbeat causing an arrhythmia which may feel like your heart is racing or skipping beats and even banging against the wall of your chest.
As the heart struggles to correct whatever is happening it will begin to divert resources away from non-essential functions, meaning that muscles in your arms and legs can start to feel weak and heavy. Many people will find it difficult to stand or walk in these moments due to the intense wave of fatigue they are experiencing all of the sudden.
Another non-vital area resources are pulled from is the digestive system during these moments. Less oxygenated blood going into the bloodstream, can cause sudden nausea, indigestion and abdominal cramps which can be mistaken for heartburn because there may be feelings of tightness and burning in the chest which is similar to acid reflux reactions.
Lack of oxygen rich blood because of a circulation issue may stop it from reaching the brain effectively, when this happens there may be feelings of confusion, disorientation, dizziness, or short term memory problems.
A silent heart attack leaves people feeling incredibly lousy, which makes it a difficult symptom to identify because that feeling is common even without having a condition. To some people experiencing a little heartburn, being distracted, stressed, and a little out of breath is just a bad day not a heart attack, but when it is accompanied by a racing heart and extreme fatigue it is likely to be more than just the typical bah humbug blahs of the average Monday.
Those who have silent heart attacks are at an increased risk of another attack due to the potential heart damage. The good news is that there is actually much you can do to help prevent yourself from travelling down that unwanted path.
According to Adriana Quinones-Camacho, M.D., a cardiologist at NYU Langone Health in New York “Lifestyle changes make a huge difference, even if you have significant family history. If it runs in your family, talk to your doctor, because it may make sense to start medications like statins. Also, find out your blood pressure and cholesterol numbers.”
Making more heart healthy lifestyle choices and habits such as eating more fruits and vegetables, being more physically active, keeping stress under control, getting enough sleep, making time to be socially active, and avoiding smoking will go along way in not just helping your heart but your overall health and well being as well.
“The best part about focusing on heart health is that it has a ripple effect. All these strategies to keep your heart strong can lead to having more energy, sleeping better, getting fit, and generally just enjoying your life more,” says Robert Greenfield, M.D., cardiologist and medical director of Non-Invasive Cardiology and Cardiac Rehabilitation at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in Fountain Valley, California.
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This article is not intended to provide medical diagnosis, advice, treatment, or endorsement.