Silent Heart Attack - Are You a Diabetic?

 

Srikant, 55 yrs, Executive, Diabetic experiences breathlessness on way to office. He consults his physician. ECG reveals Heart attack. He is rushed to the ICU.

Yes a Heart Attack, and no pain.

Ambulatory (Mobile) ECG reveals that a lot many no. of persons suffer from a silent attack, which is not associated with pain.

Patients with Diabetes are more likely to have a silent attack and this increases with age. About 90% of attacks in Diabetics are silent. This is due to the damage caused to the nerves carrying pain sensation due to uncontrolled Diabetes.

Diabetes is an independent risk factor for Coronary artery disease, and incidence is related to the duration of Diabetes. In Diabetes, not only are the attacks frequent but also tend to be more severe and associated with complications. Coronary Artery Disease is the most significant KILLER in Diabetes, because of accelerated deposition of fat in blood vessels, thus the threshold of Diagnosis should always be kept low.

It is treated like any other attack, keeping individual variations in mind.

Some Statistics on Coronary Heart Disease       

1. Prevalence of Coronary Artery Disease (CAD) has increased from 1.05% in 1960 to about 8-9.6% in 1990 in the urban population in India and 2.03% in 1974 to 3.5% in 1995 in the rural population.

2. The risk of Myocardial infarction (MI) has decreased between 1970 and 1993 by 23% in men and by 36% in women in the United States.

3. Trends in death rates have shown a 50% decline between the years 1970 and 1985 in the US and 10-15% decline in Scotland.

4. 2.5-3 times more frequent MI and 1.5 to 8.2 times mortality (studies from England, Wales, South Africa, Trinidad, Fiji, Singapore) in comparison to the local population.  

5. Average age at first myocardial infarction (MI) in Indians is 50.2 years compared to 55.5 years in white population.

6. Between ages 30-39 years age specific incidence of Heart Attack is 10:1 compared to whites, mortality from CAD in age group 30-39 years is 2.1:1 and 20-29 years, 3.1:1 compared to Western population groups.

7. 54% of Indians vs 21% whites have all three vessels diseased and arteries are very often diffusely diseased making them unsuitable for even bypass surgery.

8. 15-45% of Indians with coronary artery disease have hypertension as a risk factor.

9. Nicotine and carbon monoxide increase serum cholesterol by 3%, triglycerides by 9% and decrease HDL cholesterol by 6%.

10. One percent increase in serum cholesterol and 1.5% increase in serum LDL produce a 2-3% increase in Heart Attack incidence.

11. In North India there is a 3% incidence of diabetes but it is 7% in South India.

                                                                                                                                        

Hope you liked this blog!                                                                                                       

This blog is written by Dr. Bimal Chhajer (India's Best Heart Doctor)