Silent Heart Attacks: What You Should Know

05/20/2019 | 3 min. read

Dr. Stephen Sinatra

Dr. Stephen Sinatra

As their name implies, silent heart attacks are cardiac events that don’t give off warning signs like sharp chest pain or pain radiating down your left arm—so they’re easy to miss or shrug off as something else.

Yet, a study published in the American Heart Association journal Circulation shows that silent heart attacks are more common and deadlier than we once thought.

Researchers from Wake Forest Baptist Medical Center monitored the number of silent heart attacks and their future implications for more than 9,000 middle-aged adults. What they found is that silent heart attacks accounted for 45% of the total heart attacks experienced by the study participants.

Those silent heart attacks tripled the participants’ chances of dying from heart disease later in life. Perhaps even more troubling, those silent heart attacks were found to increase the chances of dying from all causes by 34% versus those who didn’t have a silent heart attack.

What Are the Symptoms of a Silent Heart Attack?

Symptoms of a silent heart attack tend to be unclear and vague and can mimic other health issues—so people often fail to connect it with a heart issue. Women are more likely than men to have ill-defined and vague symptoms.

With a silent heart attack, you may feel:

  • Ill-defined discomfort in the chest, neck, arms or upper back that appears to be recurring and may last from a few minutes to a few hours.
  • Unexplained shortness of breath not experienced previously.
  • Breaking out in a cold sweat and/or feeling nauseated or dizzy.
  • Unexplained dreadful fatigue.
  • Feeling the need to “burp” for relief.
  • New onset dental symptoms, such as discomfort in the jaw and/or teeth.

Feeling angina during exertion can also be a warning sign that you have “silent ischemia” (restricted blood flow to your heart) which could lead to a full-blown heart attack.

My wife, Jan, recalls a patient she cared for as a cardiac rehabilitation nurse in a hospital who felt a faint “twinge” in his chest during an exercise stress test—a symptom that would be easy to overlook or dismiss. But the electrocardiogram readout showed he was suffering from ischemia that needed to be addressed.

Who Is at Highest Risk of a Silent Heart Attack?

The risk factors for silent heart attacks are the same as other forms of heart attacks, including:

  • High blood pressure
  • Belly fat
  • Smoking
  • Inflammation
  • High blood sugar
  • Chronic stress

Age and gender can also contribute to people missing the signs of a silent heart attack. Women often have heart attack symptoms that are less dramatic than those experienced by men so they’re less likely to attribute them to a heart issue. Plus, some folks mistakenly think they are just "too young" to have cardiac concerns.

How Is a Silent Heart Attack Diagnosed?

Having a silent heart attack means you’re at greater risk of having another heart attack, one that can be far more serious. So, if you have symptoms that something is amiss—even if it seems small—seek medical care. It should be considered heart disease until proven otherwise.

Remember, 50% of the time a heart attack is your first symptom, so take heed if you're having warning signs from your body. Too often, people don’t have a second or third chance to find out what’s wrong.

Dr. Stephen Sinatra

Meet Dr. Stephen Sinatra

Dr. Stephen Sinatra is a highly respected and sought-after cardiologist and nutritionist with more than 30 years of clinical practice, research, and study. His integrative approach to heart health focuses on reducing inflammation in the body and maximizing the heart's ability to produce and use energy.

More About Dr. Stephen Sinatra