Silent Heart Attacks Common Among Older People

The occurrences of silent heart attacks in older people are common and often turn fatal. A study carried in the Sept. 5 issue of Journal of the American Medical Association focuses on the older people of Iceland. When diagnosed with cardiac magnetic resonance imaging (MRI), the researchers noticed the prevalence of unrecognized heart attacks.  

The study was conducted on 973 patients in the age group 67 to 93 years and alarmingly less than 10 percent had a heart attack with recognizable symptoms.

"The fact that there were more people with unrecognized heart attacks than recognized heart attacks suggests it's a big problem," ABC News quoted the  study author Dr. Andrew Arai of the Bethesda Md.-based National Blood, Heart and Lung Institute, a division of the National Institutes of Health.

And therein lays the problem. Unrecognized heart attacks are almost as deadly as 'full-blown' symptomatic ones, Arai said. Of the 157 people whose heart attacks went unnoticed, 44 died within eight years of follow-up.

According to Arai half of patients with unrecognized heart attack episodes recalled having symptoms they chalked up to the flu or indigestion. There could be reasons as roughly 28 percent of the study participants had diabetes and the diabetes can cause nerve damage that block warning signs of a heart attack.

The authors suggest that several factors may contribute to the high prevalence of silent attacks. "First, subclinical coronary plaque rupture occurs frequently, particularly in diabetic individuals. Cardiac magnetic resonance may detect the myocardial sequelae of coronary plaque rupture or coronary plaque erosion that either spontaneously reperfused or were nonocclusive. Second, symptom variation in acute MI (myocardial infraction) may lead patients or their clinicians to attribute MI symptoms to noncardiac causes. Third, given their propensity to be clinically detected, RMI (recognized MI) may be more severe than UMI (unrecognized MI) and impart greater lethality."

It is advisable to get checked and blood tests can quickly detect the signs of a heart attack. There are medications to restore blood blow and prevent irreversible damage to the heart or the heart muscle.