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HomeHealthBe Aware! Cough, indigestion, fatigue may lead to death: Silent heart attack

Be Aware! Cough, indigestion, fatigue may lead to death: Silent heart attack

Can you imagine the life without pain? Yes, such life might be wonderful to those who are having chronic back pain, knee pain and cancer pain. But if you have no pain then, you might miss lots of life taking medical and surgical conditions. Silent heart attack is one where you might not have pain and usually it will be misdiagnosed and patient die suddenly.

Heart attack: what does that mean?

It’s a death of part of heart tissue due to narrowing of blood vessel that causes decrease blood supply. In medical term it is known as myocardial infraction. If it is just lack of blood supply but the tissue is still alive the condition known as myocardial ischemia and with proper treatment heart tissue can goes to its normal stage.

In heart attack usually people die because the death tissue will behave strangely as we all know from our school knowledge that heart has a pacemaker cell that beat automatically. Moreover the death tissue of the heart and the surrounding cells will not follow the order of natural beats of heart and it will try to beat in their own way and lead to condition known as ventricular fibrillation where heart beats but the blood doesn’t come out from the heart. Finally the blood vessel supplying the heart muscle, brain and others vital organs don‘t get enough blood causing the condition worse and finally dead.

Typically, a heart attack produces chest pain, which may radiate to the arms, shoulders, neck, teeth, jaw, abdomen, or back. Other common symptoms include shortness of breath, nausea or vomiting, and anxiety. Anyone experiencing these symptoms should seek medical care immediately and with proper treatment patient may survive. So what will you do when you have heart attack and you do not have symptoms of such a life taking condition?

Silent heart attack is the condition where the patient may not experience above mention clinical condition, instead of that they might present with common cold symptoms, indigestion, fatigue, and headache. Patient will misdiagnosed may be just prescribe some cold medication and sent back to home but inside the body is taking his own life. So I guess, in such condition the attending physician should observe carefully with some past medical history of the patient otherwise the patient party are unaware about the condition and patient may die suddenly.

The exact reason for the development of heart attack and the absence of symptoms are not know but some theories may include:

  • Inability to reach the pain in brain during the heart attack because pain varies with person to person, some may need high stimulus to sense pain.
  • High endorphins (happy hormone) in some patients.
  • Higher production of anti-inflammatory chemicals that will block the effects of inflammatory chemicals that cause pain in heart attack.
  • Patient with diabetes may have nerve damage so in such patient heart attack is there but pain is not perceived due to nerve damage.

Diabetes itself in long term may lead to heart attack but due to nerve damage it also prevent to show clinical symptoms of heart attack in some patients.

What can be done to prevent form silent heat attack?

  • Patient with diabetes have normal sugar level
  • Blood pressure should be in normal range
  • Blood Cholesterol should be in normal rage
  • Ask for Aspirin with the physician
  • Exercise
  • Decrease stress
  • Avoid smoking
  • Maintain your weight

So, from next time if you or relatives with diabetes from long time and presented with fatigue, headache that is relief after rest, and also presented with indigestion and common cold clinical features you should be careful that might be the sign of silent heart attack.


Dr. Sanjay Maharjan, MD
Dr. Sanjay Maharjan, MD
MD in Basic and Clinical Physiology


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