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    Silent Symptoms

    Becoming aware of unrecognized heart attacks.

    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.

    Vigilance Pays

    To reduce the chance of a heart attack passing unnoticed, you can become more aware of some unexpected symptoms that accompany such an event. "Most 'silent' heart attacks really aren't silent; they're just not noticed," says Richard Stein, M.D., Chief of Cardiology at the Brooklyn Hospital Center in New York. "If questioned carefully, many patients will recall some vague symptoms, such as indigestion or back pain, that they blamed on something else at the time."

    Be extra-vigilant of symptoms if you have heart-disease risk factors, such as a family history of heart attack or other heart disease, obesity, inactivity, smoking, diabetes, high blood pressure, or high cholesterol.

    If you have risk factors, you should also talk to your doctor aboutgetting frequent electrocardiograms, Sheifer says. If an old heart attack is detected, it is wise to undergo a thorough treadmill test or otherkind of screening.

    The Voice of Experience

    Smith says his experiences have made him more health conscious. "I learned how to exercise and watch my diet, and not to delay seeking medical help if I had any symptoms at all."

    As Stein says, "If you have any doubts, go to the emergencyroom. Don't worry about embarrassment -- it's better to be embarrassedthan dead."

    Sharon Cohen is a senior editor at Shape and Fit Pregnancy magazines.

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