Health Care Quarterly:

Know the signs when a silent killer is lurking

I was just sitting down to a generous helping of my favorite evening snack — peanut butter mixed with chocolate chips. While relaxing to Netflix with my wife, my bliss was suddenly interrupted by a feeling of extreme exhaustion and mild dizziness. This had never happened to me before. I knew something was wrong and after about 15 minutes, I felt as if I was going to pass out. At this point, I asked my wife to call the ambulance.

I remember very little about the next few hours as I was rushed to the emergency room. I remember the physician telling me I had suffered a massive heart attack and that they were going to send me to the cardiac “cath” lab immediately. I didn’t even get a chance to say goodbye to my family.

When I awoke, the doctor told me I was one of the lucky ones because I had barely made it to the hospital in time. If I had waited another 10 minutes, I probably would have died.

This is a common scenario at hospitals all across the country. Too many times, patients are experiencing a heart attack but don’t recognize the symptoms until it’s too late. Although television displays dramatic heart attacks where patients clutch their chests and then faint, this isn’t usually the case. Although heart attacks can clearly occur in a dramatic fashion, they usually present with much more subtle signs. Sometimes there are few to no signs at all.

There is a common saying in medicine, “time is tissue.” It means that the longer a person goes without adequate blood flow to the heart, the more tissue damage will occur. Unfortunately, the damaged cardiac tissue does not regenerate. These damaged areas of the heart can lead to heart failure or irregular heart rhythms that may turn fatal. Therefore, getting to the hospital as soon as possible can save a persons’ heart tissues and possibly his life.

One third of heart attacks occur without any chest pain. We call them “Silent MIs” (myocardial infarctions). These patients tend to be undertreated and have poor outcomes.

Which patients are most likely to suffer from a silent MI? Older patients, women, and patients with diabetes suffer more frequently from silent MIs. For these patients, it is crucial to recognize any symptom(s) that might be a result of a serious heart condition.

Did you know that feeling “short of breath” can be a solitary sign of a heart attack? Many people are not aware that frequently the first cardiac symptoms are simply “gas-like pains” in the upper abdomen and/or chest. Other symptoms that may occur alone without chest pain are: sweating, neck or jaw pain, or shoulder or arm pain.

Sometimes there is no pain at all. Instead of pain, you may feel weak or faint.

If any of these symptoms last 30 minutes or more, you need to have a heightened concern and go immediately for a cardiac evaluation. Did you know that most heart attacks occur at rest? They also occur more commonly early in the morning.

With these subtle cardiac presentations, if something feels “different,” if you don’t feel right or if you feel like you may faint, it would be wise to get checked out as soon as possible. Talk to your physician about whether you need to have cardiac testing. It is much better to discover a problem early so it can be treated before there is damage to the heart tissues.

Another good suggestion is to reduce your risk factors for heart disease. The more risk factors you have, the greater your risk of having a heart attack. Modern medicine has shown that while some risk factors are out of our control (age, family history of heart disease, gender), there are many risk factors for heart disease that we can control. These risk factors are smoking, high cholesterol, stress, high blood pressure, poor diet and obesity.

Perhaps I should reconsider my late night snack of peanut butter and chocolate chips.

Derek Meeks is the chairman of the specialty medicine department at Touro University Nevada.

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