Silent Ischemia And The Heart Attack You Don’t Notice

SILENT ISCHEMIAThe American Heart Association estimates that 3 to 4 million Americans have episodes of silent ischemia.

And, Cardiomyopathy (heart muscle disease) caused by this silent ischemia is one of the most common causes of heart failure in the U.S.

First, a few definitions:
  • The term ischemia describes a condition in which blood flow (and oxygen along with it) are restricted. Therefore, cardiac ischemia refers to a lack of blood flow and oxygen to the heart muscle. 
  • Ischemic Heart Disease describes heart problems caused by narrowed heart arteries which prevent blood and oxygen from reaching the heart muscle. This is more commonly known as Coronary Artery Disease and can lead to a heart attack.

It is this type of ischemia that causes the usual symptoms of a heart attack such as chest pain (Angina).

Silent ischemia

  • People who experience ischemia without pain have a heart condition known as silent ischemia. They may have a heart attack with no warning.

  • People with angina (chest pain) also may have undiagnosed episodes of silent ischemia.
  • An exercise test or 24-hour portable monitors of the electrocardiogram (Holter monitor) are two tests often used to diagnose this problem.

Cardiac ischemia refers to a lack of blood flow and oxygen to the heart muscle.

  • Cardiac ischemia happens when an artery becomes narrowed or blocked for a short time, preventing oxygen-rich blood from reaching the heart.
  • If ischemia is severe or lasts too long, it can cause a heart attack
  •  (myocardial infarction) and can lead to heart tissue death.
  • In most cases, a temporary blood shortage to the heart causes the Silent Ischemia-angina-pectorispain of angina pectoris  (chest pain or pressure)
  • Silent ischemia may also disturb the heart’s rhythm.

Abnormal rhythms such as ventricular tachycardia or ventricular fibrillation may interfere with the heart’s pumping ability and can even cause fainting or sudden cardiac death.

Silent ischemia has no symptoms. Researchers have found that even if you have episodes of noticeable chest pain, you may also have episodes of silent ischemia.

SILENT ISCHEMIA RISK FACTORSMajor risk factors include:

Having a silent heart attack puts you at a greater risk of having another heart attack, which could be fatal. Having another heart attack also increases your risk of complications, such as heart failure.




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