The Link Between a Silent Heart Attack (Ischemia) and Diabetes

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Heart AttackWhen 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 that were previously undetected. In the study, men had a greater chance of experiencing a “silent” heart attack than women. Other factors associated with a greater risk of heart scarring included obesity, smoking, higher amounts of heart disease-linked calcium deposits in the arteries, and the use of hypertension medications at the beginning of the study.
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The researchers did say that the impact of these “silent attacks” had remained to be seen. That being said, the researchers added that 70% of sudden cardiac death victims show signs of myocardial scarring.

Silent Heart Attack (Ischemia) in People with Diabetes

Can you really have a heart attack and not even know it? You bet you can. A heart attack is also called a myocardial infarction, or myocardial ischemia. Angina, or chest pain, is often a precursor to a heart attack. A silent heart attack is also called silent ischemia. It will occur when there is a depletion of the oxygen supply to the heart.

It will suggest the presence of a heart attack with scarring, but the chest pain will likely be too faint to notice. Silent heart attacks also do not result in difficulty breathing, such as with a regular heart attack. It is estimated that up to 4 million people in the U.S. have had a silent heart attack.
Diabetics may not notice heart attack symptoms due to nerve damage. It is a condition called diabetic neuropathy, which can damage the nerves that control the heart. They will also mask back and chest pain that are typically linked with a heart attack. That is why diabetics should visit a doctor on a regular basis to help detect a previous heart condition.

Signs and Risk Factors of a Silent Heart Attack

There are several silent heart attack symptoms, or hints rather, that can help you recognize a silent heart attack. Symptoms associated with a silent heart attack include a sudden feeling of heartburn or indigestion, weakness, dizziness, vomiting and nausea, profuse sweating, sudden fatigue, strained muscles in the chest or back, pain in the upper back, discomfort in the upper arm area or jaw, or a sudden loss of consciousness. It is best to seek medical attention whenever one or more of the silent heart attack symptoms are noticed.

Besides diabetes, people who experience silent heart attacks may also suffer from hypertension and previous heart attacks or incidences of heart disease. Other risk factors associated with silent heart attacks include smoking cigarettes or cigars, a sedentary lifestyle, high cholesterol, and excessive alcohol consumption. There are also a number of factors as to why there is a depletion of oxygen circulation to the heart, including obstruction in the coronary arteries. The coronary arteries move oxygenated blood to the heart, but when there is a blockage a heart attack will occur. It is also important to note that heart attacks can happen anytime, especially during sleep, physical activities, exposure to cold temperatures, and sudden emotional stress.

Prevention and Treatment of a Silent Heart Attack

A silent heart attack is a potentially fatal condition, and preventative measures are very important. An electrocardiogram (ECG) is often the first test to confirm a silent heart attack. The ECG test will be able to confirm a heart attack, or if one is in progress. Basically, an ECG detects electrical activity of the heart and the presence of any electrical abnormalities. Taking a person’s medical history and a physical stress test can also help detect a possible heart attack.

Other tests that help reveal heart disease conditions include an advanced cholesterol panel, a high-sensitivity C-reactive protein exam, carotid intimal medial thickness test, and an endoPAT test. Factors in a blood test can also reveal damage left by a heart attack, including increased homocysteine levels, high lipoprotein-A, elevated fasting blood sugar, insulin and A1c, low levels of vitamin D, high uric acid levels, low GGT, and high ferritin levels.

A coronary artery calcium-scoring test is a detection method that can be delayed until you are 50 or older, unless you suffer from a major risk factor of heart disease, such as diabetes.

What is the best silent heart attack treatment or prevention method? Despite the availability of these comprehensive tests, certain steps should also be taken to help reduce your risk of a silent heart attack. When a heart attack occurs, a person is put under intensive oxygen therapy and monitored for regular heart status. Drugs like morphine and nitroglycerine are also given to relieve chest pain. Heart attack patients are also often treated with a coronary angioplasty, anticoagulants, and thrombolytic drugs.

How to Treat a Silent Heart Attack Naturally

What are natural ways to treat silent heart attacks, especially when the person also has diabetes? From a dietary standpoint, cholesterol levels should always be controlled to reduce the risk of a heart attack. The best diet to prevent or treat heart disease or a heart attack is likely the Mediterranean diet. It contains a high amount of vegetables, fruits, nuts, seeds, olive oil, a moderate amount of oily cold-water fish and organic, grass-fed, free-range poultry, a little organic red meat, and some eggs. Fiber-rich fruits and veggies also help regulate cholesterol levels.
Also, the best supplements that can help you recovery from a heart attack include coenzyme Q10 (CoQ10), L-carnitine, magnesium, D-ribose, curcumin, lipoic acid, and sources of omega-3 fatty acids such as fish oils or flaxseed oil.
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“What Are the Signs and Symptoms of Diabetic Heart Disease?” National Heart, Lung, and Blood Institute web site, last updated September 20, 2011; https://www.nhlbi.nih.gov/health/health-topics/topics/dhd/signs, last accessed November 15, 2015.
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Dr. Richard Foxx, MD

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Richard M. Foxx, MD has decades of medical experience with a comprehensive background in endocrinology, aesthetic and laser medicine, gynecology, and sports medicine. He has extensive experience with professional athletes, including several Olympic competitors. Dr. Foxx practices aesthetic and laser medicine, integrative medicine, and anti-aging medicine. He is the founder and Medical Director of the Medical and Skin Spa located in Indian Wells, California, at the Hyatt Regency Resort. Dr. Foxx is certified by the National Board of Medical Examiners... Read Full Bio »