By Harcharan S. Chann, M.D., F.A.C.C.

SILENTLY, the killer attacks It may happen during physical exertion, while balancing your ‘checkbook or even during sleep. Silent ischemia the “painless” heart attack can come and go without the victim ever being aware.

Of the 600,000 people dying annually from heart disease, one third die suddenly, presumably ‘without warning, The type of heart disease found in these victims is severe coronary artery disease, or ischemia. In this condition, the coronary arteries are partly clogged with fatty deposits of plaque which suddenly contract in spasms or are blocked by a clot, depriving the heart muscle of blood, and therefore oxygen.

THE PROCESS TAKES

years, Often starting in early life. When a critical narrowing is reached, the results are devastating. Because the major function of the two coronary arteries, which lie over the surface of the hear, is to supply the heart muscle with blood and oxygen, it is easy to envision how the heart attack occurs. When the coronary artery is blocked, the heart muscle is deprived of nutrient blood and oxygen and the muscle dies. Simply Rated, this is a heart attack.

Those that do develop chest pain are most fortunate. Their symptoms usually bring them to seek attention and treatment before a heart attack. Having symptoms, however, doesn’t mean that painless angina is not present. Each time the heart feels the pinch from lack of coronary low, it may not issue distress signal. The symptoms which are apparent may be just the tip of the iceberg.

 WHOIS AT RISK

 To develop silent heart disease? Those with the greatest number of “risk factors” factors which contribute to the development of coronary heat diseases: We can determine which things ‘we should be doing to maintain a “healthy heart”. How do we discover if our body’s main organ is not healthy if we are the victim of a disease in which there may be no ‘symptoms? Diagnosis is aided when a patient suspected of being at risk wears a portable Halter monitor that is “tuned” to read certain segments of the electrocardiographic pattern, enabling cardiologists to identify ischemic or “heart strain” signs which, most of the time, are not accompanied by symptoms (treatment with a nitroglycerin patch placed on the skin ‘once daily has been found to be capable of ameliorating the ischemia or strain).

OTHER DIAGTNOSTIC TESTS

 Include treadmill exercise testing which has the advantage of also analyzing electrocardiographic patterns. In addition, it is able to determine one’s heart rate Response to exercise (this data is Useful in predicting who is at risk earn runner events) If, through exercise testing and ambulatory monitoring, a patient is suspected of having coronary artery disease even without symptoms he may be a candidate for heart scanning or angiography.

Early discovery and treatment is ruthless, sudden cardiac death. A silent heart attack can yank life away without warning, ‘which is why aggressive screening for ischemia, especially in those persons with high risk factors, is a must.

Through “noninvasive” tests and monitoring, cardiologists can diagnose and treat potential victims, The old adage remains true: The three most important factors in heart disease are prevention, Tieventiodi and prevention! Dr. Harcharn S. Chann is a ‘member of Valley Independent Physicians, a. group of leading Central Valley doctors offering a ‘full range of specialties. He also is the founder and medical director of the Cardiac Care Physicians Medical Group. For more information on the silent heart attack, write to him in care of Valley Independent Physicians, 750 Bullard Avenue, Suite 102, Fresno, California 93710. For an appointment, call (209) 432DOCS, or (209) 4499100.

Article extracted from this publication >>  November 20, 1987