No symptoms means no heart disease.

False! Many of us tend to assume that we do not have heart disease since we do not experience the most common symptom of chest pain, also known as angina pectoris. Yet, that is seriously not true in many cases!
 

As we age, we are at a higher risk of high blood cholesterol and high blood pressure, whereby both conditions are “silent”, and do not cause any symptoms. Since there are no symptoms, elderly with these conditions might not even be aware that they are now at an even higher risk for cardiovascular diseases (CVD), given that age itself is also already a risk factor! 

​

However, you might be thinking, "Well, if there is
anything wrong with my heart, I would have felt
chest pain, especially when I exercise." It is not
wrong to think so, but this situation only applies to
chronic ischemia. In this case, the oxygenated blood
supply to the heart muscles becomes limited during
exercise due to the build-up of cholesterol plaque
over time, hence insufficient to satisfy the oxygen
demand and causes chest pain.
 

But, do you know that there are cases where people suffer from a heart attack without showing any symptoms beforehand?
 

This condition is known as acute coronary syndromes (ACS) (see Myth #1: The heart stops beating when a heart attack strikes), where a sudden blockage occurs, reducing blood flow to the heart. ACS can occur in people with or without any narrowed coronary arteries. Asymptomatic individuals with no significant blockages in their coronary arteries can also be a victim of ACS.

 

The cause of acute or sudden heart attack in these people
are because of spontaneous coronary artery dissection,
whereby the surface of a fragile coronary artery ruptures,
exposing the inner structure of the vessel to the lumen.
Upon exposure, the blood clotting system is triggered
and a clot builds up within seconds inside the small lumen
of the artery. As the clot builds up, it blocks the blood flow
of the artery. In the event of this sudden and complete
blockage, an acute myocardial infarction, or a heart
attack, occurs in a person who was previously asymptomatic.

​

​

 

 

 

 

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

​

The majority of the ACS patients are elderly older than 75 years old, with trends presenting a shift towards older adults in the incidence of myocardial infarction. Females are also more prone to spontaneous coronary artery dissection as compared to males. But younger people (below 50) have also been known to get ACS, especially with no preceding symptoms.

​

 

Hence, it is important to go for regular heart check ups even if you do not experience any symptoms as no symptoms does not mean no heart disease!

​

​

​

References

• Acute Coronary Syndrome and Heart Attack. (2015). [Video]. Retrieved from https://www.youtube.com/watch?v=lT6sGV6YkDw&t=129s 
   

• Engberding, N., & Wenger, N. K. (2017). Acute Coronary Syndromes in the Elderly. F1000Research, 6, 1791. https://doi.org/10.12688/f1000research.11064.1
   

• Higuera, V. (2017). Acute coronary syndrome: Causes, symptoms, and treatment. Retrieved 4 October 2021, from https://www.medicalnewstoday.com/articles/315332 
   

• Nishiguchi, T., Tanaka, A., Ozaki, Y., Taruya, A., Fukuda, S., & Taguchi, H. et al. (2016). Prevalence of spontaneous coronary artery dissection in patients with acute coronary syndrome. European Heart Journal: Acute Cardiovascular Care, 5(3), 263-270. doi: 10.1177/2048872613504310    
   

• Spontaneous coronary artery dissection (SCAD) - Symptoms and causes. Retrieved 4 October 2021, from https://www.mayoclinic.org/diseases-conditions/spontaneous-coronary-artery-dissection/symptoms-causes/syc-20353711
   

• Screening for Heart Disease. Retrieved 4 October 2021, from https://www.healthhub.sg/live-healthy/16/screening_heart_disease

​

​

​

​