You can have a heart attack and not even know it! Silent heart attacks or silent myocardial ischemia occur when oxygen carrying blood flow to the heart muscle is reduced without symptoms of chest pain, nausea, shortness of breath, neck/jaw/arm pain, etc. or with symptoms so mild as to not be recognized as a serious event. However, these events can be detected by various tests including EKG, or stress echocardiogram for example. Those suffering with diabetes (especially when associated with high cholesterol), hypertension, chronic kidney disease and sleep apnea are at higher risk for silent heart attacks. Other risk factors are familiar such as age, smoking and obesity. Men have a higher incidence than women. Those with silent myocardial infarctions are also at increased risk of death from not only coronary heart disease but from any cause. Perhaps surprisingly, silent heart attacks can account for as much as 45% of all heart attacks. Again, these events occur with no or minimal symptoms and can be brief. However, these events can cause injury to the heart muscle resulting in scarring and decreased function. In addition, they raise the risk of subsequent more serious events.
Who should be screened and when?