How a heart attack can look different in older adults

As individuals age, it is common to experience a decline in stamina, breathlessness, and overall physical function. However, these symptoms may also be signs of an underlying heart condition, leading many to overlook them as part of the natural aging process. Dr Aseem Dhall, Director & HOD of Cardiac Sciences at ISIC Multispeciality Hospital, notes that elderly patients often attribute their symptoms to ageing rather than considering a heart issue.

This delay in seeking proper medical attention can result in complications such as heart failure, coronary artery disease, or abnormal heart rhythms.

Some less obvious symptoms that could point to a heart problem include unexpected tiredness, shortness of breath, swelling in the feet or ankles, dizziness, reduced exercise tolerance, continuous fatigue, and unexplained weakness. Families may notice changes like disrupted sleep, loss of appetite, or difficulties performing daily activities that older adults once handled effortlessly.

Isolation, neglect, and a lack of family support can also contribute to delayed healthcare-seeking behaviour among older adults, particularly those who have become financially dependent.

Contrary to popular belief, a heart attack does not always manifest as severe chest pain. In older adults, symptoms can be subtler and include sudden breathlessness, extreme fatigue, dizziness, nausea, vomiting, unusual sweating, confusion, and weakness. Discomfort may also be felt in the jaw, neck, back, shoulder, or arms, with the vague feeling of being unwell being particularly easy to dismiss in older individuals, especially when there is no obvious chest pain.

It is crucial to take sudden or unexplained symptoms seriously in older adults, as early medical evaluation is essential, regardless of the presence or absence of chest pain.