Silent Heart Disease

Every year over 400,000 seemingly healthy Americans unexpectedly die from massive heart attacks.  These patients had no previous symptoms of heart disease typically seen such as chest pain or angina.  They lived normal lives and were physically active, able to exercise, play tennis etc., but had no idea that their coronary arteries had been progressively clogging up.

This type of heart disease is known as silent ischemia.  Ischemia is a condition where the flow of oxygen rich blood to a part of the body is restricted.  Cardiac ischemia occurs when a coronary artery becomes narrowed or blocked.  If ischemia is severe or lasts too long the result is myocardial infarction, known as a heart attack.  In most cases, this temporary blood flow shortage causes the pain of angina pectoris., but in some cases there is no pain.  This is known as silent ischemia.

Surprisingly millions of people are missing one of the body's primary warning systems for heart disease.  The network of nerves encompassing the heart is defective, so even though there is abnormal blood flow, these patients don't perceive chest pain.  One such episode of ischemia may only cause minor or no damage to the cardiac muscle, but repetitive episodes caneventually become deadly.

Episodes of silent ischemia can occur during periods of both physical and mental activity.  In fact, angina appears to be a relatively late manifestation of coronary artery disease according to Peter Selwin, M.D. cardiologist at Harvard Medical School.  He also said that silent ischemia is far more prevalent and commonly overlooked by physicians.

A group of British cardiologists at Hammersmith Hospital in London monitored 30 angina patients with portable electrocardiographs 24 hours a day for 18 months.  The results were quite startling.  As a group 1,934 episodes of ischemia were documented on the electrocardiographic data, but less than a quarter of these episodes were noted by the patients.  In other words, by far the majority of episodes of ischemia were silent.  The episodes of ischemia lasted on average 20 minutes and some as long as 80 minutes-and most of these patients had no symptoms!

On another, but similar note 50% of heart attacks occur in patients with normal cholesterol.  So having normal levels of cholesterol doesn't guarantee you won't have a heart attack. Since it has been well documented that ongoing heart disease may exist in people with no symptoms or typical risk factors, it is vital to have more reliable methods of detecting early cardiovascular disease before it's too late.

A normal exercises stress test indicates that the coronary arteries have good blood flow, but this test tells us nothing about the microvessels. Microvascular circulation can be easily measured using a relatively new method known as endothelial peripheral tonometry (EndoPat). Extensive research at Mayo Clinic has demonstrated that abnormal blood flow in your fingertip indicates impaired blood flow throughout your cardiovascular system. The test is noninvasive and has been proven to be a useful screening tool for detection of those who are likely to have a heart attack or stroke within the next 5-7 years.

EndoPat evaluates the health of the endothelium, which is the innermost lining of our blood vessels. For more than a decade endothelial dysfunction has been recognized as the critical junction between risk factors and clinical disease-it's where heart disease begins and progresses.  Endothelial dysfunction is the earliest detectable stage of cardiovascular disease. This sooner we detect signs of heart disease, the earlier we can intervene and prevent its progression. Early detection is the key!

EndoPAT is the only FDA approved device indicated for noninvasive assessment of endothelial dysfunction.

What about early intervention?

Even if you have no family history of heart disease, stroke or diabetes and have a normal cholesterol; you could still be developing heart disease. Silent heart disease might be detected with an exercise test which can detect disease in the coronary arteries, but not the microvessels. Whereas EndoPat testing is able to detect disease in the microvascular system.

With either an abnormal exercise test or low Endoscore you would know that you would be at significant risk for a major event such as a heart attack or stroke.  Armed with this information you hopefully will become motivated to adopt a more healthy lifestyle and practice the principles of healthy living we are all familiar with. but sometimes that's not enough.

My recommendation is that you undertake an even more effective and proven intervention using a safe, risk-free treatment known to reverse heart disease-External Enhanced Counterpulsation (EECP). EECP treats the entire vascular system from the top of the head to the tip of the toe including the coronary arteries.