Feeling better after a heart attack can understandably make a person think the worst is over. But being free of chest pain or other symptoms does not always mean the heart arteries are clear. In some cases, a significant blockage can still be present even when the person feels completely normal.

Affirming the same, Dr Aseem Dhall, Director & HOD, Cardiac Sciences, ISIC Multispeciality Hospital, tells indianexpress.com, “Some people may feel completely normal after a heart attack but still have a serious blockage in one or more heart arteries.”

Why can someone feel fine despite a blockage?

A heart attack usually occurs when blood flow to part of the heart muscle is reduced or blocked. The symptoms may settle after the immediate episode, but that does not necessarily mean the underlying narrowing in the artery has disappeared.

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“Symptoms can improve temporarily, but the underlying narrowing may remain,” Dr Dhall notes.

In some people, blood flow may improve naturally after the clot or blockage changes. However, this does not mean the coronary arteries are free of disease. There may also be narrowing in one or more other arteries that has not yet caused noticeable symptoms.

This is why how a person feels is not enough to determine whether their heart is at low risk after a heart attack.

Some people may feel completely normal after a heart attack but still have a serious blockage in one or more heart arteries

How do doctors check for a significant blockage?

Follow-up evaluation helps doctors assess both the damage caused by the heart attack and the condition of the coronary arteries. Depending on the patient’s situation, this may involve an ECG, blood tests, an echocardiogram, stress testing or coronary angiography.

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“This is why follow-up testing is important even when the patient feels well,” Dr Dhall explains.

The results help doctors determine whether medicines are sufficient or whether a procedure such as angioplasty may be required. The decision depends on factors including the severity and location of the blockage, symptoms, heart function and the overall risk of further complications.

What if a major blockage is ignored?

A significant untreated blockage can continue to restrict blood and oxygen supply to the heart. Depending on its location and severity, it can increase the risk of another heart attack, worsening heart function, heart failure or abnormal heart rhythms.

Dr Dhall cautions that ignoring a significant blockage can increase the risk of “another heart attack, heart failure, abnormal heart rhythms, or sudden cardiac complications in the future.”

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Therefore, feeling fine after a heart attack is reassuring, but it should not be taken as proof that the heart arteries are clear. Regular cardiology follow-up and the tests recommended by the treating doctor remain important, even when symptoms have disappeared.