Heart attacks are typically portrayed in TV and film as dramatic and traumatic. Characters may drop to the ground, clutch their chest, or roar in pain.
In Scotland, it is estimated that around seven per cent of men and four per cent of women are living with coronary heart disease, according to Public Health Scotland, which can lead to heart attacks.
In real life, suffering a heart attack is not obvious or clear cut. In fact, Patrick Fitzsimmons, a cardiologist at Penn State Health Lancaster Medical Center in the US, said “heart attacks can be much more subtle than they look on TV.”
Sometimes, heart attack symptoms are so mild that they go unnoticed. This is known as a silent heart attack. Without fast medical treatment, a silent heart attack can cause irreversible damage.
“Every second counts as a blocked artery chokes off blood flow to parts of your heart,” Fitzsimmons said. “That tissue is dying as time goes on, so the time and speed at which people seek medical attention is crucial.”
So, what is a silent heart attack?
Some silent heart attacks are caused by partial artery blockages, known as mini heart attacks. However, complete blockages can cause silent heart attacks, too. Mild symptoms don’t necessarily mean a mild heart attack.
“People can have severe coronary disease and may not have any symptoms at all,” Fitzsimmons said. “We all have different wiring and warning systems.”
A cardiologist can spot the damage from a silent heart attack on an echocardiogram, an ultrasound test that shows images of your heart. Sometimes an abnormal ultrasound is the first sign a silent heart attack occurred.
Heart attack symptoms can include chest pain or tightness that sometimes radiates down the left arm, jaw pain, nausea, vomiting, shortness of breath or fatigue. Sometimes silent heart attacks cause mild symptoms that people ignore or chalk up to other causes, like orthopaedic issues or an upset stomach.
“When people don’t recognize these symptoms as heart symptoms, they tend to come in late for medical care,” Fitzsimmons explained.
Signs of a heart attack in women, older adults and people with diabetes often include shortness of breath, fatigue or a general feeling of illness instead of chest pain, Fitzsimmons said.
“The biggest mistake people make is sitting at home with ongoing symptoms when it could be their heart,” Fitzsimmons said.
Risk factors for heart attacks include:
- Family history of heart disease
- Smoking history
- High cholesterol
- High blood pressure
- Increased age
- Overweight or obesity
- Metabolic syndrome
- Chronic kidney disease
- Physical inactivity
- History of heart attacks
Silent heart attacks can increase your risk of heart failure, strokes and sudden cardiac death.
If you get medical help for a heart attack early enough, a cardiologist can perform an angioplasty, a procedure to open blocked arteries and restore blood flow. If not, your heart will sustain damage that could cause death or require more complex treatment, like bypass surgery or stent implantation.
You can reduce your risk of heart attack by:
- Moving more more – Walking for 50 minutes five times per week can reduce your heart attack risk, said Fitzsimmons. If 50 minutes sounds daunting, start with five. Keep moving and improving each day.
- Try a Mediterranean Diet – This anti-inflammatory eating plan rich in fruits, vegetables, olive oil and lean meats can protect your heart. You don’t have to overhaul your entire diet, Fitzsimmons said. Buy a Mediterranean Diet cookbook and try the recipes three times a week. That’s enough to make a difference.
- Get your cholesterol checked – High cholesterol can clog your arteries. The recommended total cholesterol level is 200 milligrams per deciliter. Ask your doctor if you’re due for a lipid screening.
- Get screened for diabetes – Over time, untreated high blood sugar can damage the lining of your blood vessels and raise your heart attack risk.
- Tell your doctor if something feels off– “People often have symptoms a couple of weeks before they have a heart attack but don’t recognize them because they’re not chest pain,” Fitzsimmons said. “It might happen with activity, shovelling snow or walking up a flight of stairs.”
Don’t ignore suspicious symptoms that last for 20 minutes or longer. If you think you’re having a heart attack, call 999.