Examined: About 80 percent of heart attacks remain undetected - with serious consequences

Examined: About 80 percent of heart attacks remain undetected - with serious consequences

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Later dangers: About 80 percent of heart attacks are not noticed
The results of a study are likely to cause concern. Around 80 percent of all heart attacks remain undetected by those affected. In many cases, a heart attack causes little or no pain. A short dizziness, a little heartache and the symptoms are forgotten. Many doctors also trivialize and do not recognize the heart attack. However, regions of the heart muscle damaged by the infarct may remain. This increases the risk of sudden cardiac death.

Most of the heart attacks go unnoticed
The so-called silent infarction is obviously much more common than previously thought. According to a new US study, almost 80 percent of heart attacks go unnoticed and are not detected by ECG examinations, reports the dpa news agency. According to the researchers led by David Bluemke from the National Health Institutes (NIH) in Bethesda (Maryland, USA), the clinical significance of silent heart attacks is unclear. However, there are indications that the scarring they cause could contribute to sudden cardiac death. The scientists have now published their results in the journal "Journal of the American Medical Association" (Jama). Professor Thomas Meinertz, chairman of the German Heart Foundation, explained that the result obtained in the USA can probably also be transferred to Germany.

Damaged muscle tissue increases the risk of heart problems
On the occasion of World Heart Day at the end of September, it was reported that heart problems and heart attacks are often not recognized, especially in women. Health professionals are always keen to educate people about how to quickly identify a heart attack. In an interview a few months ago, Professor Dr. med. Volker Klauss, specialist for internal medicine and cardiology in Munich: “The classic signs of identification, such as devastating pain in the chest with radiation to the arms, upper abdomen, back or neck or jaw, feel significantly less compared to men frequently. They tend to have non-specific symptoms such as severe shortness of breath, nausea or vomiting. ”Those affected should also be aware of the consequences. In survivors of a heart attack, the damaged muscle tissue is replaced by scar tissue that can no longer contract. This is considered a risk factor for later heart problems. In their study, the doctors around Bluemke now wanted to determine how many heart attacks remain undetected in the US population.

Scarred heart tissue was not noticed during ECG examinations
To find out, at the start of the study they examined 1,840 people aged 45 to 84 who had no heart disease. Ten years later, they then checked them for scarred heart tissue using cardiac magnetic resonance imaging (CMR). At that time, the participants were on average 68 years old. As the researchers report, they found scar tissue on the heart muscle in 146 subjects, i.e. almost eight percent. Only 32 of these had previously been diagnosed with an infarction. In 78 percent of those affected, on the other hand, it remained unnoticed and was not noticed later in ECG examinations. According to the information, infarctions were about five times more common in men than in women. In addition, overweight people and smokers were particularly at risk.

Figures in Germany could be even higher
"The clinical significance of undetected scarring of the heart muscle remains to be seen," the study authors report. “But in more than 70 percent of patients with sudden cardiac death, but without a known coronary artery disease, previous scars on the heart muscle were found in pathological examinations. We need more studies to understand the clinical implications of such undiscovered scars. ”

Cardiologist Meinertz was not surprised by the result: “The cardiac muscle scars demonstrated in this work are probably the result of silent heart attacks. It has been known clinically for a long time that heart attacks can proceed practically without symptoms, ”said the doctor. “The clinical significance of these scars is unknown. This can only be clarified if the participants in the study continue to be observed over the long term. ”However, Professor Heribert Schunkert from the German Heart Center in Munich emphasized that the results of the very accurate study were remarkable in this clarity. He even expressed the suspicion that silent heart attacks could be more common in Germany than in the United States, since risk factors such as high blood pressure are more common in Germany. (sb)

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