Heart rhythm disorders, commonly known as arrhythmias, are linked to palpitations or a racing heart. However, a growing number of cases in India are “silent” as they have little to no symptoms until fatal complications such as stroke or heart failure occur. Cardiologists warn that these undetected irregular heartbeats are neglected by many, particularly among adults with lifestyle problems such as diabetes, high blood pressure, and cholesterol. Everyone is advised to pay attention to heart health.
Two Mumbai-based leading cardiologists, Dr Rahul Gupta and Dr Bipeenchandra Bhamre, explain why silent arrhythmias are dangerous, who is at risk, and how early detection can save lives.
Silent arrhythmias shouldn’t be ignored
“An arrhythmia means abnormality in the heart’s rhythm. So, it may beat too fast, too slow, or irregularly,” says Dr Rahul Gupta, Director – Cardiologist, Gleneagles Hospital, Parel.
He says, “While some patients experience symptoms like palpitations, dizziness or breathlessness, many individuals have no clear warning signs. These are what we call silent arrhythmias and need timely medical attention.
He adds, “One of the most common forms is atrial fibrillation (AF), where the upper chambers of the heart beat irregularly. In silent cases, patients may not realise anything is wrong until they tend to suffer from a stroke. So, irregular heart rhythms can reduce the heart’s efficiency and increase the risk of blood clots forming in the heart, which can travel to the brain and impact the quality of life. Unfortunately, many cases are picked up incidentally during routine ECGs or health check-ups.”
Dr Gupta urges everyone to prioritise heart health and to follow the doctor’s instructions.
Risk factors for silent arrhythmias
Silent arrhythmias are a common occurrence with high blood pressure, diabetes, obesity, thyroid disorders, and underlying heart disease. However, cases of silent arrhythmias are seen in patients more than 70 years old because of factors such as stress, poor sleep, and excessive caffeine or alcohol intake.
Bipeenchandra Bhamre, Consultant Cardiac Surgeon at H N Reliance Foundation Hospital and Research Centre in Mumbai, says, “Modern lifestyles are playing a major role when it comes to heart problems. Sedentary habits, long working hours, unmanaged stress, and metabolic disorders can lead to electrical instability in the heart. Even people who feel otherwise healthy may have rhythm abnormalities. Age is also another key factor, but increasing urban stress and lifestyle imbalance are lowering the age of onset in India, and many people are experiencing silent arrhythmias.
Symptoms to watch out for
In many silent cases, symptoms can also be mistaken for fatigue. Other signs can be
• Mild shortness of breath
• Light-headedness
• Unexplained tiredness
• Reduced exercise capacity
• Brief episodes of irregular pulse
Because these symptoms are non-specific, many may end up ignoring them. In some cases, the first sign may be a stroke, a fainting episode, or a sudden cardiac event, and it can be risky for some patients.
Complications of untreated arrhythmias
“If left untreated, silent arrhythmias can lead to serious complications,” says Dr Gupta. “Atrial fibrillation increases stroke risk. Persistent rhythm disturbances can weaken the heart muscle, and the patient can suffer from heart failure.”
He explains that the irregular rhythm may cause blood pooling inside the heart chambers, and there can be clot formation. Timely diagnosis will help start blood-thinning medications or rhythm-control medications, or perform procedures such as catheter ablation for the patient.
Diagnosis and management
Experts recommend regular ECGs for individuals aged 50 or those with risk factors. Wearable devices and smartwatches that monitor pulse irregularities are also helping detect asymptomatic cases and allow individuals to seek timely intervention.
Dr Bhamre emphasises, “Holter monitoring, a 24-hour portable ECG, can be beneficial when it comes to identifying intermittent rhythm abnormalities. In selected patients, longer monitoring devices may be suggested. It is necessary to stay in touch with the doctor and make informed decisions when it comes to heart health. To manage arrhythmia, it is necessary to adhere to lifestyle modifications such as exercising daily, staying stress-free through yoga and meditation, managing blood pressure and blood sugar, taking anti-arrhythmic medications, blood thinners to prevent stroke, and catheter ablation procedures.”
“Not all arrhythmias require invasive treatment,” Dr Bhamre says. “But ignoring them can be dangerous. The goal is to personalise therapy and prevent long-term damage.”
Preventive measures
Both doctors stress that maintaining a healthy weight, exercising regularly, managing stress, ensuring adequate sleep, and limiting caffeine and alcohol can keep the heart healthy.
“People with a family history of heart disease or stroke should undergo annual cardiac evaluation,” advises Dr Gupta. “A simple pulse check during routine visits can sometimes reveal an irregular rhythm.”
Dr Bhamre adds, “Heart health is not only about cholesterol and blood pressure. Electrical health of the heart should also be taken into consideration. Experts urge everyone not to skip routine health check-ups, as timely diagnosis and management can save lives.
(The author, Nivedita, is a freelance writer. She writes on health and travel.)
