A heart attack that does not produce the hallmark symptoms of chest pain and difficulty breathing. It is estimated that as many as 4 million Americans have had silent heart attacks, and diabetes raises the risk of having one.
A heart attack, also known as a myocardial infarction, occurs when low blood flow to the heart starves it of oxygen, damaging it. Most heart attacks are caused by a blood clot that blocks one of the coronary arteries, the arteries that carry blood and oxygen to the heart muscle. A clot most often forms in a coronary artery that has been narrowed by atherosclerotic plaque. Risk factors for heart attacks include a family history of heart attack, being male, diabetes, older age, high blood pressure, smoking, and blood lipid abnormalities, especially high LDL (“bad”) cholesterol levels and low HDL (“good”) cholesterol levels.
Typically, a heart attack produces chest pain, which may radiate to the arms, shoulders, neck, teeth, jaw, abdomen, or back. Other common symptoms include shortness of breath, nausea or vomiting, and anxiety. Anyone experiencing these symptoms should seek medical care immediately. But people with diabetes may not feel these symptoms due to diabetic neuropathy (nerve disease), which can damage the nerves that control the heart, as well as mask the chest and back pain that usually accompanies an attack.