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Why Do Diabetics Have Silent Heart Attacks?

Diabetes Is A Heartfelt Problem

Diabetes Is A Heartfelt Problem

By Bradley A. Radwaner, M.D., F.A.C.C. Diabetics face a special risk of heart disease, at least double that of the general population. Poorly controlled blood sugar over the long term exacts a toll on the entire circulatory system, from the large arteries that supply the heart and brain, to the tiny capillaries that deliver nutrients to the body's individual cells. When control is poor, the interior walls of blood vessels become bathed in high concentrations of blood sugar. This sets the stage for atherosclerosis, a build-up of fatty plaque that can clog arteries and eventually lead to heart attacks and strokes. Heart disease seems to act in slightly different ways in diabetics. Coronary artery disease is usually more marked with a greater build-up of atherosclerotic plaque and other debris on arterial walls. The heart muscle itself is more likely to be affected by disease in the person with diabetes. As a result, diabetics suffer a higher-than-normal death rate from heart disease and are less likely to survive a heart attack. They also experience more silent or undiagnosed heart attacks. In fact, heart attacks and strokes are by far the leading cause of death in diabetics. Although the prognosis may sound grim, heart disease is not inevitable for those with diabetes. Patients with knowledge of their disease and its effect on the cardiovascular system can make choices that will make a difference on risk and quality of life. PREVENTIVE STRATEGIES Except for the damage done by high blood sugar, the heart disease risk factors faced by diabetics are the same as those facing the rest of the population: high cholesterol and triglyceride levels; hypertension; smoking; and obesity. Physicians now know that it's not only total cholesterol levels that count, but the high density Continue reading >>

How To Tell If You've Had A Silent Heart Attack And Not Know - All The Warning Signs, Symptoms And Recovery

How To Tell If You've Had A Silent Heart Attack And Not Know - All The Warning Signs, Symptoms And Recovery

As unbelievable as it may sound, every year thousands of people have heart attacks without knowing it - and simply carry on as if nothing has happened. We've known for some time that these so-called "silent" heart attacks could occur but always assumed they were fairly rare and only caused minor damage to the heart. So I read with interest that these painless episodes are far more common - and more dangerous - than first thought. Researchers at Dukes University in the US scanned the hearts of patients who had heart disease but had never experienced a heart attack to their knowledge - and found that many showed signs of a previous, unrecorded attack. Those who'd had these silent heart attacks in the past went on to have a 10 times higher risk of death from any cause - suggesting the attack had caused both serious damage to their heart and to their general health. It means those who know they're at risk of heart disease should have regular health checks to monitor the situation. Just as deadly The main reason that silent heart attacks can be just as damaging is that, in all other respects, they're identical to a normal heart attack. Your body goes through exactly the same process - you just don't feel it. Any heart attack starts with a sudden blockage in one of the arteries that supplies the heart muscle with blood, causing part of the muscle to die. But, whether you have obvious symptoms depends on where the blockage is, the area of muscle affected and how long the arteries have been narrowing for. Why don't people feel a silent heart attack? Often the reason is that the heart has successfully managed to compensate for the lack of blood supply by using other coronary blood vessels. The absence of pain, however, doesn't mean an absence of damage. Although our hearts have Continue reading >>

Type 2 Diabetes: Silent Heart Problems

Type 2 Diabetes: Silent Heart Problems

Aug. 6, 2004 -- It's known as silent ischemia: No chest pain; in fact there are no symptoms at all before a heart attack. For people with type 2 diabetes, this is a common condition -- one that doctors should test for, new research shows. Heart disease is the leading cause of death among people with diabetes. Yet, unlike other people, these patients have few symptoms until the advanced stages -- until their first heart attack, writes researcher Frans J. Wackers, MD, a professor of cardiovascular medicine with Yale University School of Medicine in New Haven, Conn. Wackers' paper appears in the current issue of Diabetes Care. People with diabetes who are at high risk for heart disease -- men who are smokers or have high blood pressure for example -- should get a treadmill stress test for heart disease, he says. According to the American Diabetes Association (ADA) guidelines, doctors should perform stress tests to check for coronary artery disease in people with diabetes who have two or more risks factors. Doctors have had difficulty detecting early-stage heart disease in diabetes patients because there is nerve damage throughout the body. Therefore, chest pain -- which is the heart's signal that it's not getting sufficient blood and oxygen -- is dampened considerably. This is the first study to examine how common asymptomatic heart disease is in people with type 2 diabetes and how effective the screening guideline set by the ADA is. Wacker's study involved more than 1,000 volunteers in 14 centers throughout the U.S. and Canada -- all about 60 years old, with type 2 diabetes, and with no known or suspected heart disease. Some had a stress test (like a treadmill test) to determine how well the heart can handle exercise. In this case, the test determines whether people with Continue reading >>

Diabetes And Cardiovascular Disease

Diabetes And Cardiovascular Disease

Diabetes and cardiovascular disease often go hand-in-hand. Persons with diabetes are at a much greater risk for cardiovascular diseases such as heart attacks, strokes and high blood pressure. Other vascular problems include poor circulation to the legs and feet. Unfortunately, many of the cardiovascular problems can go undetected and can start early in life. Persons with diabetes often experience changes in the blood vessels that can lead to cardiovascular disease. In persons with diabetes, the linings of the blood vessels may become thicker, making it more difficult for blood to flow through the vessels. When blood flow is impaired, heart problems or stroke can occur. Blood vessels can also suffer damage elsewhere in the body due to diabetes, leading to eye problems, kidney problems, and poor circulation to the legs and feet. Risk factors include: poorly controlled blood sugars, too high or out of the normal range high blood pressure obesity abnormal cholesterol and high triglycerides lack of physical activity smoking By controlling these risk factors, patients with diabetes may be able to avoid or delay the development of cardiovascular disease. People with insulin resistance or diabetes in combination with one or more risk factors are more likely to development cardiovascular disease. Symptoms of Cardiovascular Disease The following are the most common symptoms of heart disease. However, each individual may experience symptoms differently. Symptoms of cardiovascular disease may include: chest pain shortness of breath irregular heartbeat swollen ankles People with diabetes frequently have vague or silent symptoms of ischemia and may not have typical symptoms of chest discomfort. Consideration for a cardiac etiology should be entertained if unexplained shortness of bre Continue reading >>

How Do Symptoms Of A Heart Attack Differ In People With Diabetes?

How Do Symptoms Of A Heart Attack Differ In People With Diabetes?

Question: How do symptoms of a heart attack differ in people with diabetes? Answer: Well, if you have diabetes -- particularly for a long time -- it can alter how the body responds to sort of, the heart, the pain the heart is feeling. I've studied this for many years, and we actually describe that individuals with diabetes, like yourself, may not have typical chest pain or angina pectoris when they have a heart attack. Some of these patients actually may have chest pressure, milder pressure; they may not have any pain at all in the chest, instead they may notice the acute onset of shortness of breath, or sweating, or sometimes you may even experience some weird change in your glucose level that you can't explain. And in those cases that could be what's called an equivalent -- an anginal equivalent -- for heart attack. This is a problem in patients like yourself with diabetes, because if you don't recognize you're having a heart attack because of the unusual nature of these symptoms, you may not go to the emergency room as fast as you should. And we know that when you have a heart attack, how quickly delivered those treatments for heart attack are given to you, the better the outcome you will have. So be mindful of the fact that if you have any symptoms that are unusual in the chest or affect your breathing, this could represent sort of the equivalent of heart pain, even though it's not the classic crushing chest pain you may have heard about. Next: Do Women Experience Angina And Heart Attacks Differently Than Men? Previous: How Do I Know When Shortness Of Breath Is Due To Other Conditions Such As Emphysema, Or Heart Disease? Continue reading >>

The Silent Heart Attacks That Can Strike Diabetics Without Warning

The Silent Heart Attacks That Can Strike Diabetics Without Warning

Property consultant Michael Green was adamant that his type 2 diabetes was nothing to worry about. 'It's the non-serious type,' he'd say dismissively. Michael's laid-back attitude is in some ways understandable. The father-of-one had never suffered any obvious ill-effects from the condition he'd lived with for 28 years, and he'd been diagnosed not as a result of any troubling symptoms, but by chance following a routine blood test. Compared to a family friend who had type 1 diabetes, he was lucky, he insisted. At least he didn't have to monitor his blood sugar levels every few hours, and inject insulin. Then one night, two years ago, he went to sleep and never woke up. At just 53, he'd suffered a 'silent heart attack' - a little-known complication of diabetes. A silent attack is almost symptomless and occurs without any of the chest pain normally associated with a heart attack. Yet they can be just as dangerous - if not more so - as a normal heart attack. They're also surprisingly common. It is estimated that around a quarter of the 175,000 heart attacks in the UK each year are the silent type - and people with diabetes are at greatest risk. This is because the nerve damage linked to their condition can prevent warning signals being transmitted in the usual way. This, in turn, can lead to a delay in seeking treatment and result in damage to the blood vessels and heart muscle that make the heart attack more lethal. Heart attacks occur when there is a blockage in the artery supplying blood to the heart. Normally, this is as a result of a fatty plaque breaking off from the artery wall, triggering a blood clot. When the blood supply to the heart is reduced, the body produces chemicals that affect nerves and trigger pain. Often, people describe the pain of a heart attack as a Continue reading >>

The Heart Attack You Never Knew You Had

The Heart Attack You Never Knew You Had

The image of a man clutching his chest before hitting the ground in pain is quite possibly the quintessential image of someone having a heart attack. However, that’s more of a theatrical version of a heart attack than a realistic one. New research suggests that nearly half of all heart attacks show no symptoms, yet they can still increase a person’s chance of heart failure. These “silent” heart attacks represent 45 percent of all heart attacks, yet affect different groups of people in different ways, according to a study appearing in the latest issue of Circulation, the journal of the American Heart Association. Dr. Elsayed Soliman, the senior author of the study and director of the epidemiological cardiology research center at Wake Forest Baptist Medical Center in North Carolina, says these heart attacks that show no symptoms are just as common as those that do. “Silent heart attacks are still heart attacks,” he told Healthline. Read More: Seven Warning Signs of a Heart Attack » The Silent Killer While silent heart attacks don’t give the typical warnings of a clinical heart attack, their lingering effects are still detectible by an electrocardiogram (EKG or ECG), which tests the electrical activity in the heart. To determine how common silent heart attacks are, researchers examined 9,498 participants in the Atherosclerosis Risk in Communities (ARIC) study. Of those, 703 had a heart attack—either silent or with symptoms—within nine years. African-Americans had a slightly higher rate of silent heart attacks than whites, but whites had a higher rate of clinical heart attacks. The rate of silent and clinical heart attacks was more than twice as high in men, but women died from both kinds of heart attacks more often than men. The differences between gende Continue reading >>

The Deadly Threat Of Silent Heart Attacks

The Deadly Threat Of Silent Heart Attacks

For more than six months, Harriett Cooke had been uncommonly tired, panting when she walked her sixth grade science class to the cafeteria and struggling to keep her eyes open when she drove home at night. One day, during a class trip outside the school, she just couldn’t go on. “I sat there on the side, I put my head down on the table, and I knew I shouldn’t be feeling like this,” said Ms. Cooke, 67, who lives in Durham, N.C. Making excuses, she left and stopped at her doctor’s office, where staff ordered an electrocardiogram (EKG). The test showed that Ms. Cooke had suffered a so-called “silent heart attack” at some indeterminate point, perhaps months earlier. Few people know about this type of heart attack, characterized by a lack of recognizable symptoms. Yet silent heart attacks are even more common in older adults than heart attacks that immediately come to the attention of doctors and patients, according to a recent study in The Journal of the American Medical Association. What’s more, they’re equally deadly. The research underscores the importance of paying attention to lingering, hard-to-pin-down symptoms in older adults, experts say. Many elderly men and women tend to dismiss these; caregivers shouldn’t let that happen. The JAMA report is based on data from 936 men and women ages 67 to 93 from Iceland who agreed to undergo EKGs and magnetic resonance imaging exams to detect whether heart attacks had occurred. EKGs assess the heart’s electrical activity, while M.R.I.’s look at its mechanical pumping activity. So-called “recognized” heart attacks were identified when signs of heart damage were evident, and the patient’s medical record indicated that medical attention had been sought and a diagnosis rendered. “Silent” heart attac Continue reading >>

Diabetes And Heart Disease

Diabetes And Heart Disease

People with diabetes are at a higher risk for developing heart attacks and stroke than people who do not have diabetes. Adults with diabetes are 2 to 4 times more likely to have heart disease or suffer a stroke than people without diabetes. A person with diabetes can reduce the risk of heart and blood vessel disease by knowing the “ABCs” of diabetes. A is for A1C A1C is a test that measures your blood glucose control over the past 3 months. Even a small drop in A1C reduces the risks of heart disease. You may help improve A1C with a change in your diet, medicines, and exercise routine. B is for Blood Pressure Blood that pushes too hard against artery walls (high blood pressure) makes your heart work harder. High blood pressure also can affect your kidneys. C is for Cholesterol Cholesterol, especially LDL (low-density lipoprotein), and triglycerides (tri-gliss-erides). High levels of fats in the blood may cause narrowing of the blood vessels that feed your heart and brain. It is important to have good control of your blood glucose, blood pressure, and blood lipids if you have diabetes. You should ask your doctor or health care provider 3 important questions about the ABCs of diabetes: What are my A1C, blood pressure, and cholesterol numbers? What are my treatment goals? What do I need to do to reach my goals? Treatment goals for people with diabetes (American Diabetes Association Guidelines, 2013) Hemoglobin A1C: less than 7 percent Blood pressure: less than 140/80 mmHg, (but lower goals of less than 130/80 mmHg may be appropriate for certain individuals, such as younger persons, if it can be achieved without a lot of treatment burden. Target lipid levels for people with diabetes are: Total cholesterol: less than 200 LDL cholesterol: less than 100 HDL cholesterol: Mor Continue reading >>

The Hidden Dangers Of A Silent Heart Attack

The Hidden Dangers Of A Silent Heart Attack

While we usually think of heart attacks as dramatic episodes with intense pain and shortness of breath, there is another type that often goes unnoticed: a silent heart attack. A silent heart attack can present similar symptoms to a regular heart attack, but because they are more mild in nature, they’re often disregarded as indigestion or ignored completely. What are the symptoms? Although it’s called a silent heart attack, there are symptoms to look out for just like a regular heart attack. Cardiologist and Director of the Heart Failure Unit and Department of Cardiac Rehabilitation at Concord Hospital Andrew Sindone says many people who suffer from silent heart attacks often misdiagnose themselves or pass it off completely. He says some patients won’t find out until they go to their doctor for a check up. “Someone does an ECG and says, ‘Oh you’ve had a heart attack’ and people say, ‘I didn’t know that’,” he said. These people often had the symptoms of a heart attack, like profuse sweating, shortness of breath, and chest pain, but ignored it instead of seeking medical attention. Who’s most at risk? Around 80 per cent of people who have silent heart attacks are diabetic. The nerves around the heart are often damaged in diabetics, meaning they can’t feel pain when the heart is under severe pressure. Dr Sindone says most people with diabetes, as well as those who don’t have diabetes, will notice other symptoms instead. “It’s often just a sudden onset of shortness of breath or maybe they might collapse, or they may just feel really, really tired and weak all of a sudden like they’re going to faint and they can’t get up and are totally exhausted and call an ambulance,” he said. Women are also more at risk of missing silent heart attacks b Continue reading >>

The Link Between A Silent Heart Attack (ischemia) And Diabetes

The Link Between A Silent Heart Attack (ischemia) And Diabetes

When a diabetic suffers from a silent heart attack (ischemia), it is also called a silent diabetic heart attack. In other words, the individual won’t even know that they’re having a heart attack. Many people who suffer from one disease are at risk of other diseases. That is certainly the case with diabetes and heart disease, especially when it comes to heart attacks. Take my uncle Phil for example. He’s been a diabetic for about eight years now. I’m telling him he’s also at risk of heart diseases and heart attacks. I even told Phil that type 2 diabetics have the same risk of suffering from a heart attack or dying from heart disease than those with a history of heart attacks. You see adult diabetics have death rates from heart disease approximately two to four times greater than adults without diabetes. In fact, heart disease is the leading cause of death in diabetic patients. Research Suggests That Many Americans Suffer From “Silent” Heart Attacks The scary thing is that many Americans can suffer from these “silent” heart attacks, according to brand new research published in the Journal of the American Medical Association earlier this month. For the study, a research team, led by Dr. David Bluemke from the U.S. National Institute of Biomedical Imaging and Bioengineering, analyzed heart scans of participants between the ages of 45 and 84 who were free of heart disease. They enrolled in the study between 2000 and 2002. It wasn’t until 10 years later that study participants underwent cardiac magnetic resonance (CMR) imaging with gadolinium to detect for myocardial scarring. The average age of participants at that point was 68. The scans revealed that 146 of the participants, or 7.9%, had scars from a heart attack. From that group, 78% had heart attacks Continue reading >>

Silent Heart Attack

Silent Heart Attack

Silent heart attack symptoms By definition, a silent heart attack occurs when you do not have any symptoms from your heart attack. However, it is difficult to distinguish between completely silent heart attacks and atypical heart attack symptoms you may have ignored. A silent heart attack is usually diagnosed after the fact and it may not be possible to determine when the actual heart attack happened. A silent heart attack is detected on an EKG(electrocardiogram, also called ECG) as a specific finding called “Q wave.” When you get a routine ECG done for some other reason and they see this Q wave, they ask you if you had a heart attack in the past. If you do not recall having any heart attack symptoms in the past, you probably had a silent heart attack. However, it is also possible that you may have had some atypical heart attack symptoms in the past that you ignored and did not seek medical attention. If the silent heart attack symptom was a minor discomfort, you may have completely forgotten about it. Silent heart attack due to atypical heart attack symptoms you may have ignored Strictly speaking silent heart attack does not have any symptom. However, you may be diagnosed with a silent heart attack if you had unknowing ignored one of the following atypical symptoms and did not know you had a heart attack: Chest discomfort: You may have had a vague discomfort in your chest that was not severe enough to characterize as pain. It could have been a slight uneasiness or tightness that you did not pay any particular attention to. Nausea: You may have felt somewhat nauseated for a while without any obvious reason. Sweating: You may have had an unexplained episode of sweating profusely for a while. Feeling tired: You may have felt extremely tired and exhausted for a few hou Continue reading >>

Discover The Weird Symptoms Of A ‘silent’ Heart Attack

Discover The Weird Symptoms Of A ‘silent’ Heart Attack

Not all heart attacks cause chest pain and drenching sweats: Some heart attacks may strike “silently,” causing little or no symptoms, new research from the National Institutes of Health (NIH) suggests. The researchers recruited over 1,800 people 45 and older who were free of heart disease, and then scanned their hearts 10 years later. They discovered 8 percent of the participants showed evidence of scarring—damaged tissue—on their hearts. Of that scarring, the majority went unrecognized and uncared for, and nearly half of those looked typical of a heart attack. Related: The Men’s Health Better Man Project—2,000+ Quick Tricks For Living Your Healthiest Life That means they may have experienced a heart attack and not even known it. These silent heart attacks could occur without any obvious signs or symptoms that something may be seriously wrong with your health. “In some cases, patients have symptoms that they feel are not bad enough to go to a doctor,” says study author David Bluemke, M.D., Ph.D., the director of radiology and imaging sciences at the NIH Clinical Center. Those signs and symptoms of a silent heart attack may include mild chest pain, nausea, vomiting, unexplained fatigue, heartburn, shortness of breath, or discomfort in the neck or jaw, he says. That’s right: A silent heart attack may feel a lot like a bout of the stomach bug or the flu or indigestion. Unlike those illnesses and ailments, however, even a mild heart attack is a serious medical condition: It can leave scar tissue on your heart. Related: The 4 Best Ways to Prevent a Cold And here’s why that’s a huge deal for your health: Scarring on your heart may mess with the electrical current in your heart, causing abnormal heart rhythms, or arrhythmia, says Dr. Bluemke. When that ha Continue reading >>

The Medical Minute: The Causes And Symptoms Of A Silent Heart Attack

The Medical Minute: The Causes And Symptoms Of A Silent Heart Attack

It’s possible to have a heart attack and not even know it. Maybe it’s because you’re stoic when it comes to pain and fatigue. Or maybe you write off your symptoms as heartburn or indigestion. It’s even possible that your own body is kicking up its reserves to mask symptoms of what is happening inside. No matter the reason, it’s important to know about the causes of unrecognized, or silent, heart attacks and how to prevent them. Dr. Charles Chambers, a cardiologist at Penn State Hershey Heart and Vascular Institute, says the big five risk factors for acute heart attacks also apply when it comes to the silent variety: high cholesterol, high blood pressure, diabetes, smoking and genetics. While typical heart attack symptoms include chest pain that radiates up the neck and down the arm, sweatiness, shortness of breath and nausea, the silent variety flaunt their presence less, especially among women and diabetics. “Women often experience chest pain differently, such as fatigue or tiredness, and not the typical pressure in the center of their chest,” Chambers said. “Diabetics may have damaged nerve fibers and therefore may have less ability to sense pain.” In acute heart attacks, blood clots form quickly and cause an artery to close. In silent ones, the collateral coronary arteries may have time to grow and form connections that mute typical heart attack symptoms and can protect the heart muscle from more serious damage. Often, those who experience silent heart attacks don’t even realize something significant happened. They simply feel unwell or strangely fatigued and don’t know why. Or, they may have no symptoms at all. It isn’t until medical professionals do an electrocardiogram (EKG) and note damaged tissue on the heart muscle that the diagnosis can Continue reading >>

Diabetes Makes A Person Prone To Silent Heart Attacks

Diabetes Makes A Person Prone To Silent Heart Attacks

Diabetes has become increasingly common in India, but most people still regard it simply as a disease that deprives you of the pleasures of sweets and desserts. In truth, diabetes threatens a lot more than your simple food choices. People with diabetes are two to four times more likely to suffer a heart attack or stroke than those without the disease. What Is A Silent Heart Attack? “A heart attack in which a person does not feel chest pain or other symptoms is called as a silent heart attack” During heart attack, a section of the heart muscle does not receive blood. The lack of blood flow can cause the heart tissues to die and scar. There is no doubt that every heart attack is life-threatening and requires immediate attention. In most cases, heart attack symptoms include sharp chest pain and breathlessness, but in some instances, there are no visible symptoms. A heart attack in which a person does not feel chest pain or experience other symptoms is called as a silent heart attack. The Risk To Diabetics “Around 25-30% of heart attacks in people with diabetes are silent, putting diabetics at significant risk” A silent heart attack can happen to anyone, but people with diabetes are more predisposed to experience silent heart attacks. Around 25-30% of heart attacks in people with diabetes are silent, putting people with diabetes at significant risk. The key to recovering from a heart attack is the speed at which treatment is received. Those who get the required timely medical attention have an excellent prognosis; with modern treatment, survival rates from a heart attack are as high as around 90%. In the case of a silent heart attack, the patient is not aware of the attack and valuable time is wasted, leading to permanent heart damage. Twice as many people die from Continue reading >>

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