A heart attack is a medical emergency. However, there are conditions where your heart suffers an attack and yet can remain unrecognized. Known as ‘silent heart attack’, such developments can become more fatal than an actual attack as it does not make you aware of the increased risk of heart attack in future. Also known as silent myocardial infarction (SMI), it accounts for 45 per cent of total heart attacks and affect more men than women.Researchers have found that the risk of having a silent attack is associated with hypertension – it is one of the most prominent risk factors that may facilitate heart attack. An ideal blood pressure would remain between 90 / 60 mmHG and 120 / 80 mmHG; anything above 140 / 90 mmHg is high blood pressure. In Rajasthan, nearly 7 per cent women and 12 per cent men aged between 15 and 49 have high to very high blood pressure. It will not be wrong to suggest that even if they do not have the other risk factors such as consumption of tobacco, diabetes, obesity, or cholesterol, these men and women are at an increased risk of getting a silent heart attack as they age.
High blood pressure and silent heart attack
What we eat and how we use the calories we take make a lot of difference in maintaining our heart health. Our modern, urban lifestyle makes way for food that is high in calorie but low in nutrient due to increased amount of refined flour, sugar, salt, and trans-fat. Besides, most of people live a sedentary life with low physical movement and exercises. As a result, there is a sustain build-up of fat, cholesterol, and other substances (together known as plaque) in the arteries that gradually narrows the arteries. This causes excess strain on the arteries resulting in its damage, a development known as atherosclerosis. As plaques harden the arteries, blood clots become more likely. If blood clots or plaque block the artery, the flow of blood through the heart muscle is interrupted, depriving the muscle of oxygen and nutrients. The resultant damage or death of part of the heart muscle causes a heart attack (also known as myocardial infarction or MI) .In case of a silent attack, the unidentified scarring and damage to the heartputs the person at greater risk of other heart problems. In absence of treatment, the condition may continue disrupting blood flow to the heart, so the impact could potentially be greater.
Warning signs and preventive measures
It is not true that silent heart attacks are asymptomatic – some people have symptoms, but they just do not recognize the sensations coming from their heart. The symptoms can be mild and brief, and hence, many often confuse them for regular discomfort or another less serious problem, and ignore them. The two most common problems reported are indigestion and muscle pain, where the actual cause is reduced blood flow to the heart. People may also experience nausea or excessive sweating during a heart attack which are categorised as atypical symptoms. In case you have any of the risk factors for heart attack, seek immediate medical attention if you experience one or more of the following:
– Discomfort in the center of the chest for several minutes, or intermittent (goes away and comes back). It can feel like an uncomfortable pressure, squeezing, or pain.
– Discomfort in other upper-body, such as arms, the neck, the back, the jaw, or the stomach.
– Shortness of breath before or during discomfort.
– Breaking out in a cold sweat, feeling nauseated or lightheaded.
Prevention mechanisms involve health screening to identify any existing artery blockages, and getting rid of any risk factors such as diabetes, high blood pressure , high cholesterol, obesity, and smoking through dietary and lifestyle changes. Dietary Approaches to Stop Hypertension (DASH), an eating plan to lower or control high blood pressure, can be a good starting point. Besides, just 20 minutes of exercise a day can significantly reduce your risk since sedentary increases the risk of death almost 3 times compared to being overweight but active.
By
Dr. Amit Kumar Singhal, Consultant- Cardiology, Fortis Escorts Hospital, Jaipur
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