Doctors warn: Heart attacks rarely come without signs. Here's what we ignore

Doctors have long warned that several lifestyle-related risk factors are significantly contributing to the rise in coronary artery disease.

While heart attacks are commonly perceived as sudden medical emergencies, health experts have cautioned that in many cases, the body sends out warning signs well in advance—often ignored or misinterpreted.

“Sudden heart attacks aren’t always sudden – the body often sends signals long before the event,” said Dr Joy Saibal Shome, Head of TAVI/TAVR at BM Birla Heart Hospital, Kolkata, in conversation with NDTV.

Cardiovascular diseases continued to be a leading health concern in India in 2024, with data indicating that one in four deaths in the country were linked to heart-related conditions. Contrary to earlier beliefs that associated heart disease with older adults, it has now emerged as a serious threat to men, women, and even children.

Experts urged the public to pay attention to three categories of symptoms:

Sudden symptoms, such as intense chest pain or discomfort, shortness of breath, dizziness, or loss of consciousness.
Commonly mistaken signs, including fatigue, mild chest discomfort, or indigestion—often attributed to less severe conditions.
Prodromal symptoms, which can occur days or weeks before a heart attack and may include subtle shortness of breath, unusual fatigue, or vague chest pressure. Though non-specific, these early signs are key indicators of a brewing cardiac event.

“Understanding these prodromal symptoms is crucial for timely intervention and preventing the severity of any disease,” Shome said.

Sid Das, Co-founder of eGenome, a firm working in predictive health technologies, stated, “Today’s healthcare culture does more to react to heart attacks than to prevent them. But the reality is, the body begins to signal trouble years before a cardiac event.”

He further emphasised the clinical blind spot created by the healthcare system’s dependency on periodic tests. “That’s where we lose patients,” Das said. “Subtle fatigue, breathlessness, and low-grade inflammation are not incidental symptoms; they’re early signs of cardiac stress.”

Doctors have long warned that several lifestyle-related risk factors are significantly contributing to the rise in coronary artery disease. These include diabetes, hypertension, obesity, alcohol consumption, smoking, lack of exercise, and inadequate rest.

Dr Dixit Garg, Consultant Interventional Cardiologist at Manipal Hospital Gurugram, said, “Risk factors associated with the increased incidence of coronary artery disease are diabetes, hypertension, obesity, lack of physical exercise, lack of adequate resting hours, consuming alcohol and smoking.”

According to the World Heart Federation, in 2022, 878 million adults globally were living with obesity—a stark rise from 194 million in 1990. If current trends persist, projections suggest that two in three adults aged 25 or older could be overweight or obese by 2050, fuelling a global cardiac crisis.

For individuals over 35—and particularly those with risk factors such as diabetes, high blood pressure, smoking habits, or a family history of heart disease—early screening is strongly advised.

“A basic cardiac workup, including ECG, echocardiogram, lipid profile, and increasingly, a CT coronary angiogram, can detect problems before they turn fatal,” Shome noted.

Advances in real-time biomarker analysis and artificial intelligence (AI) have allowed a new level of proactive cardiac monitoring, according to Sid Das.

“The problem is that we’re still relying on periodic tests and reactive care, while cardiovascular disease progresses quietly, continuously, and often fatally,” he said. “That’s the clinical blind spot.”

“Beyond predicting genetics, the endeavour is to catch early physiological deviation, something we’ve never been able to scale before. The next steps in healthcare development will allow us to move from episodic care to continuous risk monitoring. Especially in India, where access is uneven and first events are often fatal, this shift is critical.”

Das added, “The cardiac disease doesn’t have to surprise us, because the body whispers long before it screams; we just need to start listening.”