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Silent Symptoms
Feb. 21, 2000 (San Francisco) -- You'd certainly know if you were having a heart attack, wouldn't you? After all, you couldn't possibly miss symptoms as unmistakable as crushing chest pain or extreme shortness of breath.
Or could you? As it turns out, more than one in five peopleover the age of 65 who have heart attacks have "unrecognized" ones, according to a study published in the January 2000 issue of the Journal of the American College of Cardiology. Researchers evaluated nearly 6,000 men and women aged 65 and above. Of the 901 subjects in whom an electrocardiogram -- a test to record the electrical current that runs through the heart muscle -- indicated a prior heart attack, more than one fifth had had heart attacks that had gone undetected until the test was done. Most patients had no clear indications of cardiovascular disease when they started the study. These so-called "silent" heart attacks are of two types, says P. K. Shah, M.D., Director of Cardiology at Cedars-Sinai Medical Center, Los Angeles. "One kind is truly silent -- it has no symptoms. The other has symptoms, but they are either very mild or are ignored because they are usually not associated with heart attacks, such as sweating or indigestion."
Because these silent heart attacks go undetected, they can't be treated.This increases the chances of underlying heart disease becomingmore advanced and causing another, more serious heart attack.But with simple awareness, you can do much to reduce the risk of overlooking such a "silent" attack.
Taken by Surprise
Fourteen years ago, Joseph Smith (not his real name), an 80-year-old Californian, suffered an episode of vertigo that caused him to go to the emergency room. An electrocardiogram revealed that he had at some point in the past suffered a silent heart attack that his doctor described as "significant."
"Looking back, I couldn't think of any signs or symptoms thatI'd missed, and I was disturbed to learn that I'd had a heart attackand not known it," Smith says.
Then, eight years later, Smith experienced mild chest pains but waited three months before seeing a doctor. When he finally went for medical help, a stress test and an angiogram revealed blocked coronary arteries, and he underwent quintuple bypass surgery. Today, he's relatively healthy, considering his history.
What's Known, What's Not
Smith's case isn't unusual. Though exact numbers aren't known, many younger people also experience unrecognized heart attacks. "Unfortunately, there's no way to predict who's likely to have them," says Stuart Sheifer, M.D., a fellow in cardiology at Georgetown University Medical Center in Washington, D.C., and the lead author of the study published in the cardiology journal.
In terms of heart damage, these unrecognized attacks aren't necessarily less severe than classic ones. "The first and only symptom of a silent heart attack could be sudden death," Sheifer says. After six years of follow-up in the study, his team of researchers found that death rates from silent heart attacks were the same as those from non-silent heart attacks.
Indication
Uroxatral® (alfuzosin HCl 10 mg extended-release tablets) is an alpha1-blocker for the treatment of the signs and symptoms of BPH.
Important Safety Information
Do not take UROXATRAL if you have liver problems or if you are taking antifungal drugs like ketoconazole or itraconazole, or HIV drugs like ritonavir.
UROXATRAL can cause a sudden drop in blood pressure, especially when starting treatment. This may lead to fainting, dizziness, and lightheadedness. Do not drive, operate machinery, or do any dangerous activity until you know how UROXATRAL will affect you. This is especially important if you already have a problem with low blood pressure or take medicines to treat high blood pressure. There may be an increased risk of low blood pressure and fainting when taking UROXATRAL in combination with blood pressure medication or nitrates, or erectile dysfunction medication.
If considering cataract surgery (clouding of the eyes), tell your eye surgeon that you are currently taking UROXATRAL or have previously been treated with an alpha-blocker.
Before taking UROXATRAL, tell your doctor if you have kidney problems.
Also, tell your doctor if you or any family member(s) have or take medications for a rare heart condition known as congenital prolongation of the QT interval.
BPH and prostate cancer can cause the same symptoms. However, UROXATRAL is not a treatment for prostate cancer.
The most common side effects with UROXATRAL are dizziness, upper respiratory tract infection, headache, and tiredness.
Please see UROXATRAL full prescribing information.
VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.
INDICATION
Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.
IMPORTANT SAFETY INFORMATION
Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).
Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).
Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.
The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.
You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see Full Prescribing Information for Vivelle-Dot.
