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Why Some People Don't Know They've Had A Heart Attack

Silent heart attack is a major problem, you need to know about!

21 March, 2018
Why some people don't realise they've had a heart attack

A heart attack is understandably thought of as a shocking and traumatic event. It is not unusual for survivors to experience post-traumatic stress or anxiety after an attack.

Yet, perhaps somewhat surprisingly, cardiac incidents can sometimes take place unnoticed.

Silent attacks are, in fact, becoming more prevalent, according to Lucy Wilkinson, Senior Cardiac Nurse at the British Heart Foundation (BHF), with sufferers sometimes being diagnosed by their GP months after the event. She explains:

"Silent heart attack is a major problem in the UK. It is worryingly common for patients to visit their GP having already had a heart attack but they are completely unaware of it."

Mistaken symptoms

This, says Lucy, puts paid to the "common misconception" that the symptoms of a heart attack are only chest pains, or cold sweats and shortness of breath.

"In reality a heart attack can manifest itself in many different ways, often leading to people delaying seeing their doctor or even completely missing the event."

That's not to say there are no symptoms at all. Sufferers often mistake symptoms for indigestion, nausea or a sickness bug. They may also be unable to tell the difference from symptoms caused by a separate pre-existing medical condition, says Lucy.

"Certain medical conditions could mask the signs of a heart attack. For example people with diabetes can develop nerve damage over time, which can affect how they feel pain, and therefore make them more likely to have a silent heart attack."

I have a high pain threshold – am I more at risk?

The American Heart Association (AHA) believes there may be a link between high tolerance and unrecognised heart attacks.

According to a study published by the AHA before December,Norwegian researchers surveyed 4,849 adults who underwent a cold pressor test and electrocardiogram (ECG).

Those with silent heart attacks endured the cold pressor test significantly longer and were less likely to quit the test than those who recognised heart attack pain, the study concluded.

The BHF agrees high pain tolerance may mask heart attack symptoms, but more research will need to be committed to the area, as Lucy explains:

"Pain threshold may well be the reason for some people not noticing the symptoms of a heart attack, but more research needs to be done to help us understand what's causing others to miss the signs."

More prevalent in women

The AHA Norwegian study also found unrecognised heart attacks to be more common in women than men – 75% vs. 58%.

"It is likely to be that women in general are not recognising the signs or realising they can be at risk of a heart attack. There is still a notion that women don't get heart disease, but the reality is that coronary heart disease kills more than twice as many women as breast cancer."

Detection

GPs can use a simple ECG to detect whether someone has had a heart attack in the past. An echocardiogram can also show areas of heart muscle damage that indicate they have previously had an attack.

If these tests show signs of a previous episode, your doctor may suggest further testing, and potentially a coronary angiogram to look at the inside of the coronary arteries.

"If you have had a silent heart attack it is important to talk to your GP about whether you had any abnormal warning signs, or symptoms that could be an indication of a heart attack – or whether they want to monitor you with more regular check-ups."

Prevention

Prevention tips for a silent heart attack are the same as for a recognised cardiac incident, says Wilkinson – namely, maintaining a healthy lifestyle and getting regular exercise.

"It's so important to be aware of the signs and symptoms of a heart attack and knowing which lifestyle choices can put you at a greater risk including smoking, drinking too much or eating too much saturated fat."

Following this advice is imperative for those who have already suffered an attack, she says.

"Anybody who has had a heart attack is more at risk of having another than someone who has never had a heart attack. Often people think of a heart attack as a one-off event, but the reality is that once you have suffered a heart attack, you are living with heart disease for the rest of your life."

Credit: Cosmopolitan
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