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‘Silent’ heart attacks are more common than you think — and can be deadly

February is American Heart Month. In addition to taking medication prescribed by a physician, people can keep their hearts healthy through daily exercise and diets, such as the Mediterranean diet, and by stopping smoking. | stock.adobe.com

Everyone knows the classic signs of a heart attack: chest pain, cold sweat, the feeling of impending doom.

But what about fatigue, indigestion, shortness of breath, some discomfort in the jaw or neck? That’s probably late hours at the office, stress or something you ate, right?

Maybe. Maybe not.

It could be a heart attack, too.

“Some people have no symptoms but some just feel weakness, fatigue, chest pain or shortness of breath,” said Annabelle Santos Volgman, medical director of the Rush Heart Center for Women. “It is similar to heart attacks, but it is not severe enough for them to seek medical attention.”

Events like this are called “silent heart attacks,” and they are more common than one might think. Nearly 45 percent of all heart attacks appear to be “silent,” meaning they had no symptoms — or no symptoms that the patient could remember — research from the Atherosclerosis Risk in Communities study showed.

“It can be quite a surprise when a patient comes in and finds out,” said Steve Attanasio, director of the Cardiac Catheterization Labs and Chest Pain Center at Swedish Covenant Hospital.

Dr. Steve Attanasio | Courtesy Swedish Covenant Hospital

Sometimes, people go months or years without detection. They’ll attribute whatever they’re feeling to food poisoning, or indigestion, or maybe think they’ve just been working too hard. Sometimes, they even feel normal for a while after the discomfort has passed. Then, they won’t find out they’ve had a heart attack until they go to the doctor for another ailment or for a yearly physical.

Asim Garibovic, 49, dismissed his symptoms for months. The meetings manager for Sheraton Hotels had been fatigued, and suffered from occasional chest pain and headaches, as well as a few sleepless nights.

“It was nothing that I thought was a heart attack,” he said.

He chalked it up to work because he also moonlights for another hotel to make extra money. But in November, as he was walking to his car to pick his wife up from O’Hare International Airport, a big heart attack hit — so big, it left him in a coma for two days. Doctors didn’t think he would live. Garibovic was lucky.

“I feel like a brand new person,” he said.

But, he acknowledged, if he had seen a doctor earlier to check on what he thought were mild symptoms, he may have been able to prevent the event that nearly killed him. He just didn’t know he should, he said.

Heart attacks are common in the United States. They strike about 735,000 Americans each year, research from the American Heart Association showed. Of them, 525,000 are first-time heart attacks. About 210,000 are second heart attacks. Within that pool are people like Garibovic. For example, a 2105 study published in Journal of the American Medical Association followed 2,000 people ages 45 to 84 who did not have heart disease for 10 years. At the end of the study, they found that 8 percent of the participants had scarring in their hearts. Scars indicate a heart attack happened.

“I think anyone who survives a heart attack is fortunate, Attanasio said. “But with silent heart attacks, it is a little scarier because you don’t have symptoms.”

That doesn’t mean everyone is a ticking time bomb. The good news is that most heart disease can be prevented.

People at the highest risk of silent heart attacks are those with coronary artery disease, history of heart attacks and high risk as calculated by a risk score, Volgman said. The risk score takes into account a person’s age, weight and race, blood pressure and cholesterol levels, and whether someone smokes or has diabetes.

“Pay attention to your numbers,” Attanasio said.

Men also are more likely than women to have silent heart attacks. However, as Volgman pointed out, women have a higher risk of microvascular disease — or small vessel disease — and often are not diagnosed accurately. Silent heart attacks also happen in small blood vessels, so women should pay close attention to their symptoms, she said.

To stay healthy, doctors say that anyone who knows their history and risk factors or has had a heart attack should take all medications as prescribed by their physicians.

However, everyone can keep their hearts healthy through daily exercise and diets, such as the Mediterranean diet, Attanasio said. People also can stop smoking and watch blood sugar levels, as well.

Researchers, too, are making strides in detecting silent heart attacks, Volgman said. Stress MRIs are now finding them, so “we can be more aggressive about treating them,” she added.

Cardiologists say the biggest thing people can do to protect themselves from silent heart attacks is pay attention to symptoms, no matter how small they seem.

“Actively listen to your body. See how you handle a flight of stairs and compare that to six months ago,” Attanasio said.

And if you don’t like the results, see your doctor.

Erika Hobbs is a local freelance writer.