Silent Heart Attacks: Know the Risks

Do you know the signs of a heart attack? I’m guessing you do; the American Heart Association has done an admirable job raising awareness about heart health. We all know heart attacks usually come with chest pain or discomfort that lasts more than a few minutes, or goes away and comes back. Other symptoms include upper body pain or discomfort, shortness of breath, breaking out in a cold sweat, and nausea.

But did you know that you could also have  heart attack and not know it? That’s what a silent heart attack is. And like its name suggests, it comes with mild or no symptoms. You might think you have lingering indigestion, the flu, or passing nausea. Often you won’t even know you had a heart attack until a medical test for an unrelated reason reveals heart damage.

A silent heart attack can hit anyone at any time, but certain conditions can put you at higher risk.

Risk Factors for Silent Heart Attacks

A silent heart attack is not much different from a regular, “loud” heart attack. The risk factors are the same: smoking and tobacco use, family history of heart disease, high cholesterol, high blood pressure, diabetes, lack of exercise, and obesity.

And while the effects of silent heart attacks are usually mild, it leaves you at a much greater risk of having another heart attack. The subsequent heart attack can be fatal, or cause serious complications such as heart failure.

An Extra Risk for Silent Heart Attacks: Type 2 Diabetes

As I wrote in a previous article, a common complication of diabetes is diabetic neuropathy. Neuropathy is a condition involving damaged nerves. More than half of all diabetics develop some form of neuropathy. It usually causes numbness and tingling in the hands and feet, but in more severe cases, it can affect nerves all over the body.

When the disease causes damage to nerves leading to your heart, any sensations in that area will be muted. A heart attack that should cause terrible chest discomfort may instead feel like a slight twinge of heartburn. You may not notice anything unusual, chalking up any slight discomfort to normal aging. However, it’s a real heart attack and the damage can be serious.

One way to protect yourself from having a neuropathy-related silent heart attack is to monitor yourself carefully for nerve damage. If you catch the damage early, you may be able to slow it down with medication. Some signs of neuropathy are:

  • Difficulty exercising
  • Dizziness or fainting when you stand up
  • Frequent accidents or incontinence
  • A lower sex drive
  • Sweating excessively
  • Digestion problems

If you are having one or a combination of these problems for longer than one or two weeks, talk to your doctor about the possibility of neuropathy.

Symptoms of Silent Heart Attacks

Some people will not have any symptoms at all, and may never know they had a heart attack. In many cases, there are mild, short-lived symptoms that are easy to dismiss. You may feel slight pain or pressure in the center of your chest. Lasting indigestion, breaking out in a cold sweat, feeling light-headed or tired for no reason, shortness of breath, and heartburn are also signs of a heart attack. Women in particular may feel pain in the jaw, neck, or left arm.

After a silent heart attack, you may feel very tired or have heartburn for a prolonged period. You might notice swelling in your legs or sudden difficulty breathing. If something feels different, check with your doctor right away or call 911.

Peripheral Neuropathy: What You Need to Know

Peripheral neuropathy is a group of conditions involving damaged or diseased nerves. There are many different forms of peripheral neuropathy, mainly divided into two types: mononeuropathy and polyneuropathy. Mononeuropathy, like its name suggests, is when only one nerve is damaged. Polyneuropathy is when multiple nerves around the body are damaged.

One very prevalent type of chronic polyneuropathy is diabetic neuropathy. This condition occurs in diabetics, particularly those with poor blood sugar control.


The most common symptoms of PN are tingling and numbness in the hands and feet. Depending on which nerves are affected, you may also experience:

  • Sharp, throbbing, or burning pain
  • Diarrhea or constipation
  • Loss of bowel and/or bladder control
  • Sexual dysfunction
  • Low blood pressure
  • Sensitivity to touch
  • Lack of coordination and/or falling
  • Muscle weakness

Causes and Risk Factors

There’s no one cause of PN, since it’s not actually a single disease. It’s a group of disorders, and there are many different causes. Some of the triggers for neuropathy include:

  • Alcoholism
  • Autoimmune disease
  • Bone marrow disorders
  • Certain infections
  • Chemotherapy
  • Diabetes
  • Exposure to toxic substances
  • Trauma
  • Tumors
  • Vitamin deficiencies

There are also some cases of PN where no specific cause can be identified. However, knowing the common causes listed above can help identify people at risk for neuropathy. For example, more than half of all diabetics develop some sort of PN. Those whose blood sugar levels are poorly controlled are at higher risk.

People with kidney, liver, or thyroid disorders are also more likely to develop peripheral neuropathy. In addition, family history puts you at higher risk.

Prevention and Management

People at risk for damaged nerves should take steps to prevent developing neuropathy. The best way to prevent it is to manage the condition that may cause the damage. It will also help to make healthy lifestyle choices, by avoiding alcohol, eating a good diet, and exercising regularly.

If you have already been diagnosed with peripheral neuropathy, you can manage the condition with a healthy lifestyle. Quit smoking, treat injuries and wounds right away, and take care of your extremities.


People suffering from peripheral neuropathy often lose all sensation in their extremities. They can’t feel temperature or pain, so they may burn themselves without realizing. They may also develop sores from injuries or extended pressure they don’t feel.

If your foot becomes injured without you realizing it, it can become infected quickly. As mentioned above, it’s important to check for injuries regularly and treat them before they get infected. Allowing infections to fester untreated may result in limb amputations.

Another complication of peripheral neuropathy is increased risk of falls. Weakness and loss of sensations in the feet make falls more likely.

In order to avoid complications and control the condition, see your doctor right away if you are at risk for PN and you begin experiencing symptoms.