What are silent heart attacks?
A silent heart attack is a heart attack without the traditional symptoms. You often don’t know you are having a silent heart attack. Many people don’t find out until weeks or months later. Recent research suggests that nearly half of all heart attacks are silent heart attacks.
Symptoms of silent heart attacks
The symptoms of a silent heart attack are not as severe as those for a regular heart attack. They can often be mistaken for other conditions. Some people feel no symptoms at all. Pay attention when you feel any of the following:
- Discomfort –You may still feel pain, but it won’t be the unmistakable chest pain of a regular heart attack. You may feel discomfort in the upper abdomen, in your back, or in your jaw. It could feel like you’ve strained a muscle.
- Shortness of breath –If you are feeling short of breath or having trouble breathing doing small activities, it could be a sign of a heart attack.
- Heartburn –Mild pain in the throat or chest can be mistaken for gastric reflux, indigestion, or heartburn.
- Fatigue –Physical discomfort or feeling very tired can be signs of many things. When they happen with a silent heart attack, they are often mistaken for other things. These could include poor sleep or age-related aches and pains.
- Feeling lightheaded –If you break out in a cold sweat, feel nauseated, or feel lightheaded, you could be having a silent heart attack.
If you experience one or more of these symptoms, call your doctor right away, go to the emergency room, or call 911.
What causes silent heart attacks?
Silent heart attacks are caused by the same things that cause traditional heart attacks. This happens when part of the heart muscle is damaged or dies because it hasn’t received enough oxygen. This is often due to a blocked artery in the heart. Risk factors for silent heart attacks are also the same. They include:
- Smoking
- Diabetes
- Age (risk increases for men older than 45 and for women older than 55 [or after menopause])
- High cholesterol
- High blood pressure
- Family history of heart attack
- Race (Black people, Native Americans, and native Hawaiians are at greater risk)
- Lack of exercise
- Stress
- Obesity
- Gender (women have silent heart attacks more often than men)
How are silent heart attacks diagnosed?
Many times, silent heart attacks are found during a routine check-up. If your doctor thinks you may have had one, they may order imaging tests. These could include an echocardiogram or echo, which is a special ultrasound, or a CT scan or MRI of your heart.
These tests can show if your heart muscle has been damaged, signaling that you’ve had a heart attack. If you’ve gone to the emergency room with silent heart attack symptoms, the doctor may order blood tests.
Can silent heart attacks be prevented or avoided?
A healthy lifestyle can help prevent any kind of heart attack. This includes:
- Quitting smoking or vaping and avoiding secondhand smoke
- Decreasing alcohol consumption
- Keeping a healthy diet that is low in fat and low in cholesterol
- Exercising regularly
- Managing your stress
- Controlling your blood pressure
- Managing your blood sugar level if you have diabetes
- Seeing your doctor regularly for check-ups
Silent heart attack treatment
Normally, silent heart attacks are found long after the heart attack is over. Treatment will mostly involve taking medicines. These medicines help improve blood flow to your heart, prevent clotting, and reduce the risks of having another heart attack. They include:
- Aspirin
- Beta blockers
- Statins
- ACE inhibitors
- Fish oil
Your doctor will prescribe the medicines that are right for you. If you have had a heart attack, your doctor will also talk to you about lifestyle changes. You can make these changes to prevent more heart problems.
Living with silent heart attacks
After you’ve had a silent heart attack, you are at higher risk of having another one. This one will likely be more severe and harmful. Your doctor will likely recommend heart-healthy lifestyle changes to help reduce your risk. They include:
- A heart-healthy diet
- Working toward a healthy weight
- Managing stress
- Being physically active
- Quitting smoking
Symptoms during a second heart attack may be different than the first one. If you have any new symptoms of a heart attack or are in any doubt, call 911. Early treatment is the key to surviving a heart attack.
Questions to ask your doctor
- I feel discomfort in my chest. Could I be having a silent heart attack?
- How much risk do I have for having a silent heart attack?
- How serious was my heart attack?
- What happens now?
- Will I have to take medicine for the rest of my life?
- What is my risk of having another heart attack? Will it be more harmful than the first one?
- What lifestyle changes can I make to prevent another heart attack?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
