When we hear the word "heart attack," we immediately think of someone in a movie who clutches their chest and screams in pain before falling to the ground. True, most heart attacks come with a sharp pain in the chest. But did you know that some heart attacks come without any sound, almost like a whisper? This is what we call a "silent heart attack" in medicine. This is very dangerous because we may not realize it and may not get treatment in time.
Simply put, what is this Silent Heart Attack?
A silent heart attack is just like a normal heart attack. In medical terms, this is the same condition as ``Myocardial Infarction''. Simply put, our heart is a pump made of muscle tissue. These muscle tissue needs a constant supply of oxygen and nutrient-rich blood to function. This blood is supplied by small blood vessels called ``Coronary Arteries'' in the heart itself.
Imagine that a blood vessel has a buildup of cholesterol, which is called a plaque, and it gradually becomes blocked. One day, this plaque bursts, a blood clot forms, and the blood vessel is completely blocked. Then the heart muscle that is supplied with blood by that blood vessel stops receiving blood. When that muscle loses oxygen, it starts to die. That is what is called a heart attack.
In a normal heart attack, this happens with severe chest pain. But in a silent heart attack, this damage to the heart occurs without any symptoms, or with very minor symptoms that we don't pay much attention to. The scary thing is, the damage can be the same in both cases. But because there are no symptoms, you don't know that you need treatment.
Do we really understand the difference in symptoms?
This is the most important thing. We need to know the difference between the symptoms of a normal heart attack and the symptoms of a silent heart attack. Imagine if your friend suddenly said he had chest pain, you would immediately take him to the hospital. But if he said, "I feel a little dizzy," we wouldn't pay much attention to that, would we? Look at this difference.
| Minor Symptoms of a Silent Heart Attack | Severe symptoms of a typical heart attack |
|---|---|
| Fatigue for no reason: Extreme fatigue and a feeling of weakness that lasts for days. | Severe chest pain: A severe pain in the middle of the chest, as if it were being squeezed with an iron band, as if an elephant had stepped on it. |
| Feeling like indigestion: A burning sensation in the stomach, a feeling similar to gastritis. Many people think this is gastritis. | Shortness of breath: A sudden feeling of suffocation. |
| Flu-like: body aches, body feels uncomfortable, as if you have a fever. | Pain radiating to the left arm: Chest pain that spreads down the left arm, possibly to the neck, jaw, or back. |
| Muscle-rolling pain in the back or chest: A feeling like your muscles are sore from exercise. | Dizziness and cold sweat: Feeling dizzy and cold and sweating. |
| Unexplained pain in the jaw, neck, or shoulders. | Nausea and vomiting. |
The most important thing is to never ignore even a minor symptom like this, especially if you have risk factors for heart disease.
Who is more at risk?
Some people are more likely to have a heart attack than others. We call these "risk factors." Some of these we can control, but some we can't change.
Risk factors we can control
- High Blood Pressure: When blood pressure increases, the heart feels a lot of strain and blood vessels are damaged.
- High Cholesterol: "Bad" cholesterol (LDL) builds up in blood vessels and clogs them.
- Diabetes: People with diabetes are more likely to have blood vessel damage due to high blood sugar levels. Silent heart attacks are especially common in people with diabetes and in women.
- Smoking: Smoking is one of the biggest enemies of the heart. It constricts blood vessels and increases the risk of blood clots.
- Obesity and lack of exercise: When body weight increases and exercise is lost, it opens the door to everything from high blood pressure to cholesterol and diabetes.
- Excessive stress: Continuous stress is also not good for the heart.
- Unhealthy diet: Foods high in oil, salt, and sugar are bad for the heart.
Risk factors we cannot change
- Age: The risk increases with age, especially after the age of 45 for men and after menopause for women.
- Family history: If one of your close relatives (mother, father, sibling) has had heart disease at a young age, you are also at higher risk.
How do you know if you have had a silent heart attack?
This is the biggest problem. Often, a person only finds out they've had a silent heart attack weeks, months, or even years later. That too by accident. Imagine you go to a doctor for some other reason and have an `ECG` (Electrocardiogram). That's when the doctor sees that your heart has already been damaged.
The tests usually used to diagnose this are:
- ECG (Electrocardiogram): This tests the electrical activity of the heart to see if there is any damage to the heart muscle.
- Echocardiogram (Echo): This is like a scan of the heart. It can check how the heart is working, how it pumps blood, and whether there is any damage.
- Blood Tests: During a heart attack, certain enzymes (Cardiac Enzymes) from the heart muscle are released into the blood. These can be tested.
- Stress Test: An ECG is taken while walking on a treadmill to see how the heart responds to exertion.
What to do if you have any doubts? What are the treatments?
This is an emergency! If you have any symptoms of a heart attack, no matter how mild, do not try to go to the hospital on your own.
1. Call 1990 immediately: An ambulance is the best and safest option. The paramedics in the ambulance can begin the necessary first aid while taking you to the hospital.
2. Go to the nearest hospital's Emergency Department (ETU): If you cannot wait for an ambulance, get to the ETU as soon as possible with someone's help.
At the hospital, the doctors will quickly assess your condition and begin treatment.
- Providing oxygen.
- Giving medications like aspirin to stop blood clots from forming.
- Giving medicine to reduce pain.
- Treatment to open the blocked blood vessel. There are two main methods for this:
- Angioplasty: In this procedure, a small tube called a ``catheter`` is inserted through the leg or arm into the blocked blood vessel in the heart, and a balloon is inflated to open it. Often, a mesh-like structure called a ``stent`` is inserted to prevent it from getting blocked again.
- Coronary Artery Bypass Graft (CABG): If a blood vessel is severely blocked, a piece of blood vessel from another part of the body (such as the leg) is taken and a new path is created around the blocked area. This is a major operation.
What should be done to prevent something like this from happening again?
After a heart attack, you have to turn a new page in your life. It's not something to be afraid of, it's a second chance you get to protect your heart.
- Take the medicine your doctor prescribes exactly: You will be prescribed several medications to take for the rest of your life. These include medications like ``Statins`` that lower cholesterol, ``Antiplatelets`` that control blood pressure, and ``Antiplatelets`` that prevent blood clots. Don't miss a single day of these.
- A heart-healthy diet: Reduce oil, salt, and sugar as much as possible. Include vegetables, fruits, greens, and small fish in your diet.
- Exercise: Walk for at least 30 minutes a day. Ask your doctor what kind of exercise is right for you.
- Stop smoking completely: Don't smoke a single cigarette.
- Control your weight: Maintain a healthy weight for your height.
- Manage stress: You can reduce stress by doing things like meditation, yoga, and engaging in a hobby you enjoy.
- Participate in Cardiac Rehab Programs: Some hospitals have rehabilitation programs specifically for heart patients. From these, you can learn a lot about exercise, diet, and mental wellness.
Take-Home Message
- A heart attack doesn't always come with severe chest pain. Sometimes it can come on suddenly.
- Never ignore even minor symptoms like unexplained fatigue, indigestion, fever, or back pain, especially if you have risk factors.
- If you have conditions like diabetes, high blood pressure, or cholesterol, it is very important to keep them under control.
- If anyone in your family has heart disease, you should also see a doctor regularly for checkups.
- If you have even the slightest suspicion of a heart attack, don't waste time and immediately call 1990 or go to the nearest hospital Emergency Department (ETU) . Every second is worth saving your life.
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