The Deadly Threat of Silent Heart Attacks

(New Old Age Blog – New York Times) – 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 attacks were also signified by heart damage, but in those cases evidence from medical records was lacking.


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