Cardiac surgeon reveals why silent heart attacks are a risk for even young and fit Indians: Causes to prevention tips
Can you have a heart attack and not know it? Silent heart attacks can be particularly dangerous because they often go unnoticed, and the damage may only be discovered later.
In an interview with HT Lifestyle, Dr Niranjan Hiremath, senior consultant and cardiovascular and aortic surgeon at Apollo Indraprastha, New Delhi, said that silent heart attacks are a growing concern among young Indians. Also read | Cardiologist warns of alarming rise in heart attacks among young smokers under 40: Know symptoms, causes and prevention
Dr Hiremath said, 'It's an alarming thought — someone in their 30s or 40s, apparently healthy and active, suddenly collapses or ends up in an emergency room, diagnosed with a heart attack, which they never saw coming. These are not just rare exceptions anymore. In this digital era, increasingly, cases of 'silent heart attacks' are being reported among youngsters, who show no obvious signs of heart trouble.'
Estimates suggest that 22 percent to 60 percent of all heart attacks are silent, and that such attacks may be more common in women or people with diabetes, according to the Cleveland Clinic. But what exactly is a silent heart attack, and why is it affecting people who appear to be in the prime of their health?
Dr Hiremath said: 'Unlike the dramatic chest-clutching scenes we generally associate with heart attacks, a silent heart attack can occur with little or no noticeable indications. Medically known as a 'silent myocardial infarction' — it damages the heart muscle just like a regular heart attack, but goes overlooked, often until much later.' He added that sometimes, symptoms are so mild or unusual that they are brushed off as fatigue, acidity, gas-related problems or muscle pain.
According to Dr Hiremath, the stereotype of a heart patient being overweight, sedentary, or elderly no longer stands. He said that 'many teens with healthy-looking bodies and active lifestyles are now part of heart disease statistics. 'Stressful work environments, irregular sleep cycles, processed foods, smoking, drinking, and excessive gym routines without proper heart checks are all part of the problem,' Dr Hiremath said.
He added, 'Another major risk factor is genetics. In general, Indians are genetically more prone to heart disease at an earlier age due to smaller coronary arteries and a higher prevalence of diabetes and cholesterol issues. So even if someone looks fit from the outside due to their physique, they may be carrying silent risk factors inside.'
The tricky part about silent heart attacks is the lack of typical symptoms. 'But some subtle signs can still be there — mild chest discomfort, breathlessness during exercise, unexplained fatigue, pain in the jaw, neck or arms, dizziness, or indigestion-like discomfort – which are often ignored or misread as something harmless, especially by the youth,' Dr Hiremath said.
He added, 'It's also common for people to assume that being slim or going to the gym daily automatically protects them from heart related issues. But physical appearance or physique doesn't always reflect what's going on inside the arteries.'
Even if you're a teen and have no symptoms, according to Dr Hiremath, getting an annual health check-up — including ECG (electrocardiogram), cholesterol tests, blood pressure, and if necessary, a stress test — can help detect early warning signs. He said, 'Individual with family history of heart disease, diabetes, or high blood pressure should be extra cautious. Also, fitness should be holistic — combining regular exercise and gym, a balanced diet, adequate sleep, and stress management. Over-exercising without medical clearance or extreme dieting can do more harm than good.'
Dr Hiremath also spoke about how by being aware of the risks and taking proactive steps, people can reduce their likelihood of experiencing a silent heart attack and improve their overall cardiovascular health.
He suggested you start with small, sustainable lifestyle changes: 'Quit smoking, cut down on processed food and sugar and manage your weight. Also, practice yoga, meditation or deep breathing to control stress. Sleep at least 7–8 hours daily. And most importantly, don't ignore what your body is trying to tell you. If something feels off/bad, get it checked.'
'The face of heart disease in India is changing. It's no longer about age — it's about awareness. A silent heart attack doesn't announce its arrival, but the damage it causes can be lifelong or, worse, fatal. Whether you're a busy professional, a gym enthusiast, or just someone who feels fine, your heart deserves attention. Don't wait for a warning or signs — stay ahead of it,' Dr Hiremath concluded.
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
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