Silent heart attacks, known as silent myocardial infarction (SMI), account for 45% of heart attacks. They are described as “silent” because they occur without the usual, recognisable symptoms of a heart attack; but can still lead to a myriad of more serious – and potentially fatal – health complications if left untreated over an extended period.
In line with this year’s World Heart Day theme of “Use Heart for Every Heart,” Sunway Medical Centre, Kuala Lumpur, seeks to empower Malaysians to take care of their cardiovascular health by highlighting the possible dangers of a silent heart attack and how one can be swiftly spotted and prevented.
Dr. Patrick Tiau, Consultant Cardiologist at Sunway Medical Centre, has highlighted that in recent years, cardiovascular disease has remained the leading cause of death both in Malaysia and globally. However, Dr. Patrick informed that nearly half of all heart attacks are mistaken for less serious problems and can increase one’s risk of losing their lives to coronary disease.
“We have come across many patients who have dismissed the early warning symptoms as simply feeling tired, indigestion, nausea, or sweating. By the time they seek out medical treatment for these symptoms, they are shocked to learn that what they are experiencing is actually due to a reduced blood flow to their heart, and that has caused them to have a silent heart attack,” Dr. Patrick said.
Typical symptoms of heart attack include chest pain often described as a weighted sensation; radiating pain in the arm, neck, or jaw; sudden shortness of breath; sometimes, sweating and dizziness might not be present.
Dr. Patrick explains that we can generally get a clearer picture of risk factors by looking at two categories: non-modifiable risks vs modifiable risks, i.e., lifestyle adjustments.
Factors that Cannot be Changed (Non-modifiable)
Age
The risk of experiencing a silent heart attack increases as an individual grows older.
Gender
Men have been noted to be more susceptible to incidents of silent heart attacks than women. However, women are more prone to a higher risk of complications after experiencing one, especially if they are diabetic.
Genetics
People who have a family history of heart disease are at increased risk of a heart attack.
- Factors that Can be Changed (Modifiable)
Smoking
Chemicals in cigarettes stimulate one’s heartbeat and can dramatically increase one’s risk of heart attack.
High cholesterol
Individuals with elevated cholesterol levels can form atherosclerotic plaque in their blood vessels, which reduces blood flow to the heart.
High blood pressure
Having high blood pressure puts extra strain on the heart muscle which, over time, causes the heart muscle to stiffen, thicken and perform less optimally.
Body weight
Individuals who are overweight or obese, especially when their weight tends to sit at the waist, are more likely to develop heart disease even if they do not have any other risk factors.
Physical inactivity
Regular exercise helps protect the heart by keeping other risk factors in check, including cholesterol, blood pressure, diabetes, and obesity.
For patients who have experienced a silent heart attack, Dr. Patrick emphasised the importance of thorough cardiac evaluation and cardiac risks optimisation, which include consistently taking the necessary prescribed medications.
“Once you go home from the hospital, it is essential that you keep taking your medications as prescribed, as these will ensure your heart health is kept in check, possibly for the rest of your life.”
As for the mental repercussions of silent heart attacks that patients may go through, including feelings of shock, sadness, and anxiety, Dr. Patrick assures that this occurrence is normal, and advocates the right type of support for those feelings to pass.
“Some people find it helpful to join a support group where they can talk with others who have been through a similar experience or seek out companionship and encouragement through avenues such as the gym, or yoga classes.”
Whether it’s a common or silent heart attack, even making small changes to our daily lifestyles can go a long way in reducing one’s risk factors. Such as regularly monitoring blood pressure and cholesterol; getting sufficient, aerobic exercise; quitting smoking; eating a balanced diet of fruit, vegetables, lean meats and whole grains, ensure that one’s blood pressure, cholesterol and blood sugar are well-controlled.
“Undeniably our heart health is essential to allowing us to have a well-balanced and fulfilling life. The heart itself is the first and last sign of life that is responsible for, quite literally, keeping us going. In combatting heart attacks, the most important thing to remember is that prevention is definitely better than cure,” Dr. Patrick advised.
Most importantly, informing a doctor as soon as possible about any unusual symptoms can help diagnose silent heart attacks through specialised testing, such as with an ECG, echocardiograms, CT coronary or angiograms, as well as cardiac markers and exercise stress testing.