A silent heart attack is a heart attack that occurs without symptoms or with unrecognized symptoms. A person might have a heart attack and not know it until they receive a diagnosis weeks or months later.
A silent heart attack is also known as a silent myocardial infarction. It describes a heart attack with very mild or no symptoms. This can result in a person not receiving a diagnosis until weeks, months, or years later. Although a silent heart attack may not have obvious symptoms, it still damages the heart. People with a silent heart attack are at greater risk of a second, more severe heart attack.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Learn more.
A silent heart attack is a lack of blood flow to the heart, often resulting from blocked arteries, that occurs without pain. Because there is no pain, a person may not know they have had a heart attack and may not seek medical attention.
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This was also significantly higher than individuals who did not experience heart attacks, who had a 30% 10-year survival rate.
People who have had a silent heart attack are also at an increased risk of other complications, such as heart failure and stroke.
According to another 2018 study, a person who has had a silent heart attack has an estimated 35% higher risk of heart failure than a person without a history of heart attacks. People in their early 50s or younger have an even greater risk increase.
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According to the AHA, silent or unrecognized heart attacks may occur more often in females than in males.
Risk factors for a silent heart attack, which are the same as for a recognized heart attack, include:
- high cholesterol
- hypertension
- obesity
- smoking
- age
- a family history of heart disease
Some people may not experience any symptoms or signs of a silent heart attack, while others may experience nonspecific symptoms that they do not connect to a heart attack. These
- excessive, prolonged fatigue
- indigestion
- a feeling of a strained muscle in the back or chest
- shortness of breath
- dizziness
- malaise
- trouble sleeping
- sweating
- nausea
The duration of a silent heart attack can vary. If a person experiences symptoms of a possible heart attack, even if the symptoms are sublte, they should seek medical attention immediately.
The longer the heart goes without blood flow, the more severe the damage is.
An individual who suspects they have symptoms of a heart attack
A lack of oxygen-rich blood to all or part of the heart leads to a heart attack.
In some cases, a portion of plaque can break free and form a blood clot. If the clot grows, it can cause a blockage that prevents blood from reaching the heart.
Although this is less common, a severe spasm or tightening of a coronary artery can also lead to a heart attack. The spasm stops blood from reaching the heart. Health experts do not know the exact cause, but several factors may play a role, including:
Since a person will likely not notice symptoms or associate them with a silent heart attack, they may receive a diagnosis after the heart attack has occurred. A doctor may not diagnose a silent heart attack until they check for other conditions.
The following tests can help a doctor diagnose a silent heart attack:
- electrocardiogram
- echocardiogram
- stress test
- computed tomography to assess coronary arteries
- coronary angiography
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People should avoid using the term “anxiety attack” when describing their symptoms to reduce possible bias that could lead healthcare professionals to an incorrect diagnosis.
When a person presents with heart attack symptoms, an emergency room doctor will perform ECG and blood tests to help diagnose a heart attack. If there is a heart attack, they will call a cardiologist to assist with further treatment, such as emergency stent placement if necessary.
Immediate medical therapies may include:
- aspirin, which prevents clotting
- other anticoagulants, such as heparin
- nitroglycerin, which improves blood flow and reduces the burden on the heart
- beta-blockers
- oxygen therapy
If doctors diagnose a previous silent heart attack, they may recommend that a person take medications such as the following to help lower the risk of a future heart attack:
- aspirin
- statins
- beta-blockers
- blood pressure-lowering medications such as ACE inhibitors or angiotensin receptor blockers
A person may not know for several years that they have had a silent heart attack. They may only discover it when they visit a doctor for a routine exam or other health issues.
Some people may experience decreased exercise tolerance, fatigue, or an increased heart rate after a heart attack.
It is advisable for a person to seek guidance from a doctor about steps to take after a silent heart attack.
The outlook for a person who has had a silent heart attack is similar to the outlook for people who have noticeable symptoms of a heart attack. A person will have an increased risk of:
- another heart attack
- heart failure
- stroke
- sudden death
Making small lifestyle changes may help improve a person’s outlook.
Actionable steps an individual can take to improve their outlook include:
- regularly monitoring their blood pressure and cholesterol
- exercising regularly
- informing a doctor about any unusual symptoms
- avoiding smoking
- eating a balanced diet with plenty of fruits, vegetables, lean meats and fish, whole grains, and limiting processed foods high in salt and sugar
A silent heart attack occurs without recognizable symptoms. People may not learn that they have had a silent heart attack until months or years later.
Possible symptoms include fatigue, a feeling of a muscle spasm in the back or chest, and nausea.
Treatment will depend on when a person discovers they have had a heart attack.