24-Hour Crisis Hotline: (877)SAFEGBC or (877)723-3422 Mental Health & Substance Abuse Issues

6502 Nursery Drive, Suite 100
Victoria, TX 77904

Pain Management
Basic InformationLatest News
Expectations, Concerns Vary With Age for Adults at Pain ClinicMusic May Soothe the 'Savage Beast' of Post-Op PainThis Fanged Fish Might Someday Help Ease Your PainSteroid Shots Offer No Long-Term Relief for Low-Back PainInitial Rx Can Affect Likelihood of Long-Term Opioid UseOpioid Dependence Can Start in Just a Few DaysOpioid Painkillers and Xanax or Valium a Deadly Mix: StudyDiazepam Not Beneficial for Acute Low Back Pain in ERKids' OD Risk Rises When Opioids Left Out at HomeChronic Pain More Likely for Poor, Less Educated: StudySome Docs May Help Fuel Opioid Abuse EpidemicTry Drug-Free Options First for Low Back Pain, New Guidelines SayTwelve Percent of Women Fill Opioid Rx After Vaginal DeliveryLow Back Pain? Relax, Breathe and Try YogaOpioids and Alcohol a Dangerous CocktailTreatment of Hips Beneficial in Patients With Low Back PainCommon Painkillers Don't Ease Back Pain, Study FindsHigh Pain Tolerance Tied to 'Silent' Heart Attack RiskWhat You Need to Know When Prescribed an Opioid PainkillerDiscussing Opioid Risks With Patients Reduces MisuseVitamin D Replacement Improves Chronic Widespread PainCelebrex May Not Pose Bigger Heart Risk Than Similar Drugs: StudyMany Take Opioids Reluctantly for Back Pain: Survey'Fake Pills' May Help Ease Back PainHealth Tip: Need Pain Relief?DEA Puts Quota on Production of Opioid PainkillersRisk of Opioid Addiction Up 37 Percent Among Young U.S. AdultsCould Prescribed NSAID Painkillers Raise Heart Failure Risk?Opioid Epidemic Costs U.S. $78.5 Billion Annually: CDCReview Suggests Safe, Effective Ways to Relieve Pain Without MedsFDA: Opioids Plus Sedatives Pose Fatal OD RiskNon-addictive Painkiller Shows Promise in Animal TrialsNighttime Sleep Disturbance Common in Chronic PainCannabis Provides More Pain Relief for Men Than WomenStudy Finds Links Between Chronic Pain, Depression in CouplesAddiction Risk Low for Seniors Taking Post-Op Opioids: StudyDoctors Urged to Prescribe Lower Doses of Opioids, No RefillsPain Raises Risk of Opioid AddictionCommon Surgeries Raise Risk for Opioid Dependence: StudyDoes Medical Marijuana Reduce Need for Other Meds?Programs to Spot Painkiller Abuse Work, But Are UnderusedTighter Opioid Laws in U.S. Haven't Eased MisuseLong-Acting Opioids May Increase Risk of All-Cause MortalityOpioid Painkillers Raise Deadly Heart Risks for Some: StudyPatients Often Prescribed Extra Painkillers, Many Share ThemNew Synthetic Drug Linked to Dozens of Deaths Across U.S.Opioid Prescriptions Drop for First Time in Two DecadesChronic Pain May Trigger Many Cases of Painkiller Addiction: SurveyHealth Tip: Things That Can Aggravate Arthritis Pain
Questions and AnswersLinks
Related Topics

Depression: Depression & Related Conditions
Medical Disorders
Mental Disorders

High Pain Tolerance Tied to 'Silent' Heart Attack Risk

HealthDay News
by By Amy NortonHealthDay Reporter
Updated: Dec 21st 2016

new article illustration

WEDNESDAY, Dec. 21, 2016 (HealthDay News) -- People who are less sensitive to pain may be at increased risk of having a "silent" heart attack, a new study hints.

Chest pain is one of the "classic" symptoms of a heart attack. But many people have so-called silent heart attacks, where they notice no obvious symptoms.

"Almost everyone knows what a heart attack is. When we hear about it, we think of chest pain and [emergency] medical care," said Dr. Andrea Ohrn, the lead researcher on the new study.

"But what's less known is, many people experience heart attacks without knowing it -- without ever receiving a diagnosis," said Ohrn, a fellow at the University of Tromso in Norway.

No one knows why that is. But the new findings suggest that pain tolerance might be a factor.

Using a standard test of pain sensitivity, Ohrn's team found that people who had a silent heart attack in the past generally had a higher pain tolerance than people who'd sought treatment for heart attack symptoms.

When the researchers dug deeper, the connection appeared to be stronger in women than men.

That's an interesting finding, but it's unclear what to make of it at this point, said Dr. Nieca Goldberg, medical director of the Women's Heart Program at NYU Langone Medical Center in New York City.

The main takeaway, Goldberg said, is that people should know the "atypical" symptoms of heart attack.

Those include pain in the upper back or jaw, shortness of breath, nausea and heartburn-like pressure in the upper abdomen.

"We need to be more vigilant in educating people that chest pain is not the only symptom of heart attack," said Goldberg, who wasn't involved in the study.

The findings, published Dec. 21 in the Journal of the American Heart Association, came from a long-term health study of people living in Tromso, Norway.

One study visit involved a standard pain-sensitivity test where people plunge a hand into cold water for as long as they can stand it, for up to two minutes.

At the next study visit, participants underwent electrocardiograms -- which can detect signs of a past heart attack, even if it was unrecognized at the time.

Of over 4,800 adults who had both tests, it turned out that 8 percent had previously had a silent heart attack. Just under 5 percent had ever had a diagnosed heart attack.

When the researchers compared the two groups, they found that people who had a silent attack had, on average, greater pain tolerance.

It's possible that people who tolerate cold-induced pain are also less sensitive to pain caused by reduced blood flow to the heart, Ohrn said.

But, Goldberg said, it's not clear how often "silent" heart attacks truly caused no pain or other symptoms. Some people may simply have not realized the seriousness of their symptoms, and chose to bear them instead of seeking help.

There were differences between men and women in the study. Overall, more men had suffered a heart attack -- 19 percent versus 7 percent of women.

But silent attacks accounted for three-quarters of all heart attacks among women, compared with 58 percent among men.

According to Ohrn's team, that's in line with past studies: Women are more likely than men to have atypical heart attack symptoms, and their heart attacks are more likely to go undiagnosed.

It's not clear how pain sensitivity fits into that picture.

In this study, women generally had less pain tolerance than men. But the connection between greater pain tolerance and silent heart attack was stronger among women than in men.

It's possible, Ohrn said, that women with diagnosed heart attacks have particularly severe symptoms. "It may be that it 'takes more' symptoms to have your heart attack recognized if you are a woman," she speculated.

The bottom line, according to Ohrn, is that it's important for doctors to be on the lookout for less-obvious heart attack symptoms, especially in women.

"Absence of chest pain should not lower doctors' alertness toward heart disease," she said.

Sometimes the red flags pop up in the longer term, Ohrn noted. Breathing problems and swelling in the legs, for instance, can be signs of heart muscle damage from a previous, undiagnosed heart attack, she said.

Silent attacks, Ohrn said, are just as serious as ones that cause obvious chest pain -- carrying similar risks of death or repeat heart attack over the long term.

And that, Goldberg said, underscores the importance of prevention. A healthy diet, regular exercise and controlling risk factors like high blood pressure and high cholesterol are all critical, she said.

More information

The American Heart Association has more on hard-to-recognize heart attack symptoms.