To your health: Know the signs of silent heart attacks in women

By Alfred Casale - To Your Health | January 24th, 2017 6:00 am - updated: 6:00 am.

I have been graced beyond all ability to measure by the presence of remarkable, strong and amazing women of all ages, in all parts of my life from my first breath to today.

It’s no surprise that I’m distracted as I write this on Sunday by the TV in the background rolling images of crowds of people, it seems more women than men, many clad in pink, marching together all over the world.

Despite the social media posts that mostly seem to come from polarized and largely unjustified, obstinately held extreme positions on both sides, I have to admire the majority of the marchers who focus on asserting their just claim to fairness, respect and recognition.

As I think of the six generations of women in my own family who I’ve been blessed to know, from my great grandmother, Babci Brzenk, through both Babcis Casale and Cembor, Regina, my loving mom, my life’s treasure Mary, our light, Kate and now her cherished Rowan, a personal commitment to women’s causes seems inevitable. And that’s even before the life-altering influence of female professional colleagues and friends, both past and current are taken into account. I guess I’ve always been a feminist.

Let’s make sure that equality extends to recognition of heart disease.

The classic signs of a heart attack portrayed in the media are dramatic and unmistakable. We see men clutching their chests, struggling to breathe through the excruciating pain and chest pressure of their heart attacks. However, in real life the symptoms of a heart attack can be much subtler, especially in women. In some cases, they may go completely unnoticed until a doctor identifies the damage done to the heart through a routine checkup or electrocardiogram (EKG). As many as 45 percent of all heart attacks fall into this category and are considered “silent heart attacks.”

Just because a silent heart attack may have had few symptoms as it occurred doesn’t make it any less dangerous. Just like any heart attack, it could have been fatal, and even though you survived, it does increases your chances for future health problems.

Symptoms of a silent heart attack

One of the things that makes a silent heart attack so dangerous is that there may be no symptoms at all. When there are symptoms, they are usually mild and may be mistaken by both the women who suffer them and their physicians for something else, like anxiety.

The following symptoms may be signs of a silent heart attack:

• Soreness in the chest, arms or back: The pain is usually not sharp and may feel like the soreness you experience after a workout, which is what women often mistake it for. In reality, the pain comes from your heart being starved for oxygen due to a blockage in your arteries.

• Shortness of breath: If activity that is normally easy for you makes you short of breath, it may be a symptom. The heart pumps oxygen-rich blood throughout your body; when it’s not pumping effectively because your heart arteries are blocked, you may have trouble breathing.

• Indigestion: Heartburn or an upset stomach that is not caused by a heavy meal could be angina, a heartburn-like chest discomfort resulting from a lack of blood flow to the heart during a heart attack.

• Throat, neck or jaw discomfort: You may have a feeling of tightness or discomfort in these areas. If it’s not related to another condition you already know about, it could be a sign of a heart attack.

• A vague feeling of doom: Many heart attack patients – including those experiencing a silent heart attack – report a feeling of uneasiness or that something isn’t right. If you feel this way for no explained reason, you should call your doctor.

Who is at risk?

A silent heart attack has the same risk factors as a classic, recognized heart attack. These risk factors include high blood pressure, high cholesterol, smoking, a family history of heart disease, obesity, diabetes, inactivity, stress and increasing age. Follow the advice I’ve so frequently included in these pages to prevent both the obvious and silent heart attacks. This includes exercising regularly, eating a balanced diet low in processed food, lots of fruit, vegetables and whole grains, getting your cholesterol, blood sugar and blood pressure tested regularly, aiming for a healthy weight, controlling stress and above all, avoiding smoking.

If you feel your risk for having a heart attack is higher than average talk to your doctor. And if you think you or someone is having a heart attack, even a “quiet” one, call 911. We have tremendously successful ways to help but we can’t read minds. If you’re thinking about calling for help, do it. Don’t worry about making a fuss, we’d love to, you deserve it!

Alfred Casale To Your Health Casale To Your Health

By Alfred Casale

To Your Health

Dr. Alfred Casale is chairman of surgery for the Geisinger Heart Institute, co-director of the Cardiovascular Service Line for the Geisinger Health System and Associate Chief Medical Officer of the Geisinger Health System and Chair of the Geisinger Heart Institute. Readers may write to him via [email protected]