The idea of a heart attack that we don’t feel is confusing and scary for most people. When one thinks of a heart attack, we often think of the typical crushing chest pain we are used to seeing on TV. The truth is, most heart attacks do not give you any symptoms. This means they either don’t cause any symptoms, or that the symptoms they cause are so mild you can’t feel them.
How can this happen?
The heart itself does not have a way to let you feel pain coming from it. When the heart is hurt, as in a heart attack, the symptoms come from the parts of your body that are around the heart, like the lungs, the pericardium and the stomach. This is what causes the pressure or burning sensation in the center of the chest. If a heart attack happens slowly or is small enough, the parts around the heart can miss it—and so will you. Silent heart attacks tend to occur more often in older people and those with diabetes.
As we get older, it is harder for us to feel a heart attack. This is probably because the parts of the body responsible for sensing pain or pressure in the chest also get old and less sensitive. This is why older people who show up to the hospital with heart attacks usually complain of something besides the typical chest pain (angina). Most often they say they are out of breath when they were never out of breath before. Diabetes damages some of the nerves responsible for alerting you of a heart attack. This is the reason why diabetics are more likely to experience silent heart attacks.
Another reason why a heart attack can happen without symptoms is the body’s ability to adjust to changes in blood pressure. When we walk, run or change our position, the heart and the body play a complicated balancing game to keep the blood pressure steady and allow us to stay awake and active. Our blood vessels clamp down or open up, and the heart runs faster or slower, depending on the situation. If a small heart attack takes place that affects the way blood is pushed around, the body can adjust to it, just as it would day to day.
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