"Silent" heart attacks

Claudia Hammond reports at BBC,

Heart attacks occur when the supply of blood to the heart becomes blocked, usually by a blood clot. Despite what’s happening in the body, sometimes people feel no chest pain at all, which means they delay getting help. Even with mild chest pain, many assume they have indigestion and only discover later that they’ve had a heart attack after an electrocardiogram in hospital shows damage to the heart. Sometimes this is known as a silent heart attack. A study published in 2016 found this could happen in as many as 45% of heart attacks.

...There are also patients who knew that they were ill but not why. They feel pain in the jaw, neck, arms, stomach or back and feel short of breath, weak or light-headed. They might sweat or vomit. It’s the combination of symptoms rather than the severity of chest pain that allows for a diagnosis.



...It is often said that these heart attacks without chest pain are more common in women, leading women to delay getting help and reducing their chances of survival. In order to establish whether this really is the case, researchers in Canada in 2009 set out to measure the symptoms of a heart attack systematically, by studying 305 patients undergoing angioplasty. This is where a blocked blood vessel is reopened by inflating a small balloon inside it. The procedure can briefly mimic the symptoms of a heart attack, so while the balloons were inflated patients were asked to describe what they could feel. They found no differences between men and women in terms of chest discomfort, arm pain, shortness of breath, sweating or nausea, but women were more likely to have pain in the neck and jaw in addition to chest pain.

...So the lesson is that a crushing chest pain is very serious and could indicate a heart attack, but so could a collection of other symptoms, therefore we need to consider the possibility of a heart attack even when it doesn’t seem quite like in the films.

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