Heart attack: The two lesser-known signs warning you may be having a silent heart attack

Brian May says he’s ‘overwhelmed’ by heart attack response

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A silent heart attack, or a heart attack that does not have the traditional symptoms, account for 45 percent of heart attacks and strike men more than women. What are the two lesser-known warning signs of a silent heart attack?

People can mistakenly assume the sluggish feeling they are experiencing could be due to ageing or other factors.

However, blockages in coronary arteries could be the culprit.

When blood flow to the heart muscle is decreased, a person gets tired more easily with a sluggish feeling in their body.

Silent myocardial infarction (SMI) or silent heart attacks account for up to 50 percent of the 100,000 heart attack hospital admissions each year.

They’re known as silent since they lack the intensity of classic heart attacks, such as chest pain, stabbing pain in the arm, or sweating and shortness of breath.

Yet internally they’re identical to a normal heart attack whereby the blood supply to the heart is suddenly blocked by a build-up of fat and other substances in the arteries that feed it.


This causes damage to the tissue and can be cumulative, leading to potentially fatal blockages.

Sometimes SMI is truly silent, said Jerome Ment, a consultant cardiologist at University Hospitals Birmingham NHS Foundation Trust.

He continued: “There are obvious risk factors for having a heart attack such as excess weight or a family history of heart issues, but often it can be difficult to predict who may have one.”

Some people who simply report not feeling well or feeling fatigued go on to have a heart attack hours later.

Sometimes, the chest pain is there, but the nausea is much more prominent so people may mistake the symptoms for the flu.

The key is to know the risk factors and if you’re generally healthy and you wake up with what you think is the flu, you probably have the flu.

But if you’re obese, sedentary, have high blood pressure and a family history of heart disease, you have to take your symptoms more seriously.

We know, for example, that those with type 2 diabetes are more vulnerable to silent heart attacks. This may be because the condition impairs the nerve supply to the heart so there is no pain, said Ment.

He added: “But then more women suffer silent heart attacks than men and we don’t know why.

“Not all heart attacks need immediate treatment, though unchecked they can be fatal.

“A complete blockage of the arteries is very time dependent the longer you wait, the more damage to the heart muscle.

“If you’ve had, say, vague flu-like symptoms for a number of weeks then see your GP so you can be referred for further tests.

“You can’t mitigate against silent symptoms.

“That’s why it’s important to live a healthy lifestyle and be aware of the risk factors and that not all heart attacks present with chest pain.”
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