Can you get a heart attack without noticing it? | Heart attack

Can you get a heart attack without noticing it?

There is the possibility to get a heart attack without noticing it. This type of heart attack is also called “silent heart attack” because its typical “symptom” is the absence of symptoms. Especially the sudden stabbing pain or the feeling of tightness that normally occurs suddenly are not noticed during a silent heart attack.

Early warning signs such as tiredness, poor performance, reduced resilience or even nausea and vomiting can occur days or weeks before the attack. However, these signs do not immediately indicate a heart attack. A silent myocardial infarction occurs particularly when the pain-conducting nerves are damaged in any way.

In this case, the resulting pain cannot be transmitted to the brain. Therefore it is not felt. A typical disease in which silent heart attacks occur more frequently is diabetes mellitus (the “diabetes”).

The increased sugar levels firstly increase the risk of a heart attack, and secondly cause nerve damage, so that a pain transmission from the heart to the brain is not always present. Other neurodegenerative diseases, i.e. diseases in which nerve fibers are destroyed, can also be causes for the lack of symptoms of a heart attack. The infarction process is divided into the following pathological changes in the heart muscle:

• Phase of early undersupply of the heart muscle The cells receive less energy than they need for their function, the heart contraction (contraction of the heart to transport blood into the body).

  The contractile force of the heart decreases.

• Phase of cell death The reduced supply of the cells leads to their death.
• Phase of scarring The myocardium (muscle cells) begins a remodelling of the left ventricle in the early phase of the heart attack, which is called remodeling. The wall thickness of the heart muscle decreases at the site of the infarction, so that the ventricle widens here and also changes its original shape overall. As a result of the destruction of the muscle cells, the wall tension of the heart increases, which increases the expansion of the ventricle.At the same time the oxygen consumption of the still intact heart muscle tissue increases.