It’s hard to imagine that something as serious as a heart attack could go unnoticed. But as many as 1 in 4 heart attacks are “silent,” meaning the symptoms go unnoticed or are mistaken for less serious conditions such as heartburn, muscle pain or simply not feeling like yourself.
Research has found that silent myocardial infarction (silent MI) without a history of traditional heart attack increases a patient’s risk of heart failure, heart tissue damage and subsequent heart attacks. Because these events cause no symptoms, regular and proactive heart care is vital to avoid permanent heart damage or even death.
Who’s at risk for silent MI?
Anyone can suffer a silent MI. The risk factors are the same as for a traditional heart attack: high cholesterol, high blood pressure, family history, lack of exercise and tobacco use, just to name a few. But a few patient populations are at increased risk:
- Patients with diabetes: Diabetes affects many body processes, which can change the way these patients experience the vague symptoms of silent MI. Sometimes the only hint is a loss of blood sugar control.
- Older patients, particularly women: Silent MI often leaves these patients feeling fatigued or generally unwell, or it might cause back pain. We emphasize women because, in general, they tend to brush off cardiovascular symptoms more often than men.
A silent heart attack can cause serious, long-term heart damage. While medications such as statins are effective to prevent future heart events, leading an optimal lifestyle is the best way to preserve your heart health. Avoid smoking, eat a nutritious diet and maintain a healthy body weight to reduce your heart attack risk by as much as 50 percent, compared to just 25 percent with medication alone.
Related reading: Dr. Taylor discusses silent MI in a WTOP Radio news article.
3 ways we detect silent MI
Electrocardiogram
The EKG is our primary tool to detect silent MI. This test shows us your heart’s electrical system and can show whether you’ve suffered any heart damage. For example, I cared for a young, overweight man at MedStar Heart & Vascular Institute who was transferred to us in poor shape. He was in his early 30s, and he had trouble breathing and was retaining fluid. Something just didn’t feel right about his condition, so we ordered an EKG.
We found evidence of a previous silent MI, which led us to the discovery of a completely blocked artery that led to heart damage and his vague symptoms. These discoveries helped us get to the root of the problem and focus his care plan before another heart attack could occur.
Echocardiogram
This test employs sound waves to test how well the heart is working. If an area of the heart isn’t functioning properly, we’ll order additional testing to determine whether it has been damaged by an unrecognized heart attack. If you have vague symptoms you can’t put a finger on or simply feel “off,” talk to your doctor about getting tested for silent MI.
Stress test
For this test, we’ll ask you to walk or lightly jog on a treadmill while we monitor your heart with an EKG. If the heart shows distress during exercise, you may need additional workup to evaluate your heart arteries.
More intensive tests can tell us deeper information if we need it. Based on the cumulative results, our heart team will devise a care plan to minimize your risk of further heart damage and future heart troubles.
Anyone who experiences unexplained symptoms—even if it’s just a feeling that something is not right—should get their heart checked out by a cardiologist. Too many heart attacks go unrecognized. Proper evaluation and treatment can help ensure better heart health in the future.
