Many Heart Attacks Go Unrecognized
Study Highlights Risk of Hidden Heart Attacks
Feb. 14, 2006 -- People often have heart attacks and don't realize it,
according to a new study.
The study appears in the European Heart Journal. Its findings
- In people aged 55 and older, 43% of heart attacks happened unrecognized
until an incidental EKG was done, which showed evidence that one had
- Women were more likely than men to have unrecognized heart attacks.
Heart attacks damage the heart, making future heart problems more likely.
People with undetected heart attacks could have a false sense of confidence
about their heart health, note the researchers.
They included Jacqueline Witteman, PhD, of the epidemiology and
biostatistics department at Erasmus University in the Netherlands.
Tracking Heart Health
More than 5,100 people in the Dutch city of Rotterdam participated in the
study. They were about 67 years old when the study started in the early 1990s.
None had a known history of heart attacks or evidence of unrecognized heart
attack on a baseline EKG.
Participants got EKG tests, which check the heart's electrical activity.
After a heart attack, an EKG is likely to have abnormal findings revealing past
heart attack. This is due to heart muscle injury caused by a heart attack.
EKG tests were done at the study's start and again at follow-up visits
during the 1990s. Most participants got at least one follow-up EKG by the late
The researchers' goal: See which people had heart attacks and how often
those heart attacks went undetected.
Hidden Heart Attacks
Overall, 43% of the group's heart attacks went initially undetected. They
were only discovered later during the scheduled EKG follow-ups. Previous
studies have estimated that between 4% and 44% of heart attacks go
unrecognized, write Witteman and colleagues.
In their study, heart attacks were more likely to go unrecognized in women
than in men.
A third of the men's heart attacks went undetected without EKG. So did more
than half (54%) of the women's heart attacks.
That gap may stem from different heart attack symptoms or understanding of
those symptoms in women, the researchers note.
"It should be noticed in this respect that women and their doctors have
traditionally worried about mortality from breast and gynecological
malignancies, rather than heart diseases," they write.
Warning Signs of a Heart Attack
For both sexes, heart attacks aren't always a chest-pounding,
Heart attack symptoms can include:
- Chest discomfort
- Feeling light-headed
- Pain or soreness in the arm, neck, or back that lasts several minutes
- Feeling sick to your stomach
- Feeling short of breath
- Feeling sweaty
- Feeling fatigued
Those symptoms may or may not mean a heart attack is happening, so emergency
medical care is a must at the first sign of possible heart attack symptoms.
Don't try to diagnose yourself, and don't wait to see if the symptoms pass.
Periodic EKGs might help screen for undetected heart attacks in people aged
55 and older, write Witteman and colleagues. However, their study didn't
include a formal cost-benefit analysis to back that idea.
"I don't think that based on our study we can say that all people aged
55 years and older should seek periodical [EKG] screening," Witteman tells
WebMD, in an email.
"In our study, we didn't investigate this issue. We do think that the
role of [EKGs] in the prevention of heart disease should be evaluated," she