Aheart attack occurs when blood supply to the heart muscle is totally lost due to complete blockage of the coronary artery, which supplies blood to the heart. Such an attack is usually associated with symptoms like the sudden onset of...
Aheart attack occurs when blood supply to
the heart muscle is totally lost due to complete blockage of the coronary
artery, which supplies blood to the heart. Such an attack is usually associated
with symptoms like the sudden onset of severe pain at the centre or left side
of the chest, excess sweating, uneasiness or restlessness, nausea, vomiting
and/or shortness of breath. The symptoms can persist for more than half an
hour, and require urgent medical attention.
However, in certain individuals, these
symptoms may be minimal or there may be no symptoms of chest pain or chest pain
that may be mistaken as heartburn, indigestion, muscle pain, etc. This kind of
attack, sometimes missed or mistaken for some other issue, is considered a
silent heart attack.
Young equally at risk
A silent attack is more frequent in those
who smoke, are overweight and/or hypertensive, diabetic and those who have had
prior heart attacks. It’s a misnomer that a heart attack only affects those
above 50-60 years of age. A younger healthy individual — man or woman — less
than 50 years of age can also experience a heart attack. Symptoms of the attack
in the young can be often mistaken or misdiagnosed and hence ignored, leading
to serious heart problems. Women are more likely to have a silent heart attack
due to sheer negligence or misinterpretation of chest pain.
A common medical problem
Such cases are very frequent. A silent
heart attack is of two types — without many symptoms and misinterpretation of
pain chest as indigestion, muscle pain, heartburn, etc.
Impact on body
A heart attack, whether silent or with
marked chest pain, is a major emergency, which requires immediate medical
treatment. Delayed treatment can result in permanent damage to heart muscles,
which may later manifest as heart failure, arrhythmia (irregular heartbeat) and
sudden cardiac death. A heart attack missed the first time does invite a second
attack later because of lack of treatment, and this can result in even more
serious consequences. A silent attack has a worse outcome as compared to the
timely treatment after the episode.
Preventive measures
Prevention requires adopting a healthy
lifestyle that includes a balanced diet with adequate intake of vegetables,
fruits, cereals and fibres; minimum salt intake, avoidance of deep-fried or
fast foods, packed snacks, bakery products and alcohol. A regular 30-45 minutes
of moderate to vigorous exercise at least five days a week is a must.
Management of risk factors for heart attack such as hypertension, diabetes,
being overweight, physical inactivity and smoking plays an important role in
its prevention.
How to recognise a silent attack
The symptoms of easy fatigability,
shortness of breath and pain in chest on exertion or during emotional stress
can be signs of a silent heart attack. Immediate medical attention and getting
done a few simple tests such as an electrocardiogram (ECG) and echocardiogram
can help in diagnosis of a missed silent attack.
Treatment options
The initial two to three hours after the
onset of symptoms of an attack are called the golden period. If treatment such
as thrombolytic drugs or coronary angioplasty is provided during this window,
the damage to heart is less. However, during a silent attack, this option is
missed. As there is a delayed presentation of days after a silent heart attack,
the doctor needs to assess the damage already caused by a coronary blockage by a
battery of tests. There are certain medicines which have to be taken by every
heart attack patient for years. Good drug compliance and regular medical
follow-up are a must to avoid further attacks and to avoid the complications of
a missed silent attack.
Precautions afterwards
Follow a healthy lifestyle, control
weight, and take appropriate treatment to control blood pressure, diabetes and
high cholesterol. Have good drug compliance and a regular medical follow-up.
Recognise the symptoms of a heart attack and take immediate medical assistance
to avoid further silent heart attacks. In conclusion, a silent heart attack can
be as dangerous as a diagnosed heart attack, and it’s essential to take due
precautions after experiencing one.— The writer is professor,
Department of Cardiology, Advanced Cardiac Centre, PGI, Chandigarh.
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