PAEA Surgery End Of Rotation (EOR) Practice Exam

Which group is most likely to experience silent myocardial infarctions?

1. Older adults

2. Diabetics

3. Smokers

4. Hypertensives

The correct answer is: Diabetics

Diabetics are particularly prone to silent myocardial infarctions due to several factors associated with diabetes, such as neuropathy and autonomic dysfunction. Neuropathy can diminish the perception of pain and discomfort, which are typically associated with a heart attack. This lack of symptom awareness means that individuals with diabetes are less likely to experience the classic signs of myocardial infarction, leading to a higher occurrence of silent events. Additionally, diabetes often coexists with other cardiovascular risk factors, further increasing the risk of myocardial infarction. The combination of impaired pain perception and the presence of multiple risk factors makes it crucial for healthcare providers to remain vigilant in monitoring cardiac health in diabetic patients, even in the absence of typical symptoms. While older adults, smokers, and individuals with hypertension can also experience myocardial infarctions, they are more likely to present with recognizable symptoms. The unique characteristics of diabetes, including its impact on nerve function and pain perception, highlight why this group stands out in relation to silent myocardial infarctions.