How to Detect Fake Heart Attacks

Talking about fake heart attacks may seem strange, but it's a clinical picture that describes a multiple syndromes that seem like heart attacks, but really aren't. Learn more about them in this article!

Written and verified by the doctor Leonardo Biolatto.

Last update: 27 May, 2022

Fake heart attacks are characterized by chest pain, and this situation is already stressful. After all, we all think that chest pain is associated with a heart problem, which triggers alarms and anxiety.

However, chest pain doesn’t always come from the heart. In fact, most of the time, this type of pain doesn’t mean something serious but is associated with inflammatory or anxiety problems. In any case, because of the certain possibility of a cardiac cause, it must be carefully studied.

This is how fake heart attacks appear. As its name suggests, a fake heart attack is a clinical picture where the symptoms suggest the presence of a heart attack, but another process is actually taking place in the body.

Several syndromes hide behind the fake heart attack, and although medicine recognizes its manifestation as such, there isn’t a concrete agreement on which diseases are fake heart attacks and which aren’t. Perhaps the only consensus is the one that recognizes hyperkalemia as the main cause.

Hyperkalemia is the increase of potassium levels in the blood. When it appears, the patient feels chest pain and is accompanied by nausea or vomiting. The pain is so intense that it raises the suspicion of a heart attack. Moreover, it’s very common in diabetics and hypertensive patients, which increases the suspicion.

Let’s take a closer look.

Laboratories for false infarction

A key issue in the medical care of patients with chest pain is the availability of nearby laboratories to run some basic tests. These include troponin and ionogram.

The troponin test detects the presence in the blood of that protein, which is indicative of acute myocardial infarction when found above certain values. The test isn’t completely sensitive, but doctors estimate that it can rule out up to 60% of chest pains that aren’t heart attacks.

This simple determination would improve hospital admissions and reduce false diagnoses. The fact is that it isn’t available in all health centers, nor is it requested by all physicians.

Electrocardiograms aren’t as efficient as troponin in ruling out fake heart attacks. Sometimes, some tracings of the study look like an ongoing heart attack even if it isn’t. This is in addition to the fact that the specialists must read the electrocardiogram correctly, unlike troponin, which expresses a rounded value.

Broken heart syndrome

Behind some fake heart attacks, the reason is a clinical picture known as broken heart syndrome. The symptom is, of course, acute and intense chest pain.

The diagnostic problem it poses is that it alters the electrocardiogram and can even vary laboratory values, simulating a heart attack that isn’t happening. These patients end up undergoing a cardiological intervention that finds the arteries in perfect condition.

The cause that originates it’s a very powerful and sudden state of stress, in general, derived from a distressing situation or bad news. It has been described in people who receive bad news, such as the death of a relative.

The name of the syndrome used to be different, despite being a recently recognized health issue. It was previously called Takotsubo cardiomyopathy because the images of these hearts resembled a Takotsubo, which is a vessel used by fishermen in Japan.

Broken heart syndrome always evolves favorably, with almost no complications. In a few weeks, patients recover their normal electrocardiogram and laboratory values.

Tietze’s syndrome

A common cause of fake heart attack symptoms is costochondritis or Tietze syndrome. This is an inflammation of the cartilage that joins the ribs to the sternum.

It’s frequent in young women and in people who have made some occasional effort with both upper limbs. It usually evolves in a benign way, disappearing after days or weeks without intervention. In any case, almost all patients receive anti-inflammatory drugs.

The chest pain is the one that triggers our alarm. To distinguish it from a real infarction, the physician usually presses the ribs and the sternum, looking for pain on palpation, which doesn’t happen when the origin is cardiological.

Even if it’s a fake heart attack, you should visit your doctor

As we said before, chest pain requires a study to rule out serious cardiological causes, including acute myocardial infarction. For this reason, you must consult a professional when you feel this pain.

It’s very likely to be a harmless problem, but the doctor will determine this and give us the necessary guidelines.