Silent Heart Attacks: Signs, Symptoms and Recovery

Usually, a blood clot causes a heart attack by keeping blood from flowing through one of your coronary arteries. Less often, a coronary artery spasm or injury to your coronary artery wall can cut off your blood flow.

Heart attacks can happen when you’re asleep or awake. They can happen when:

• You just went through something very physically or emotionally stressful.
• You quickly become more physically active.

How common is a silent heart attack?

Researchers estimate that 22% to 60% of all heart attacks are silent. Silent heart attacks may be more common in women or people with diabetes.

What are the symptoms of a silent heart attack?

A heart attack causes chest discomfort that doesn’t go away with rest or medication, in contrast to stable angina, which occurs with exertion and goes away with either. However, the symptoms that you don’t typically identify with a heart attack are known as silent heart attack symptoms. You might not have any symptoms at all or only minor ones. You might not be aware that you’ve suffered a heart attack.

Symptoms of a silent heart attack can make you feel like:

• You have the flu.
• You have a sore muscle in your chest or upper back.
• You have an ache in your jaw, arms or upper back.
• You’re very tired.
• You have indigestion.

Symptoms of a traditional heart attack may include:

• Chest pain that lasts more than a few minutes.
• Shortness of breath.
• Dizziness.
• Discomfort in your upper body.
• Lightheadedness.
• Cold sweats.
• Nausea and vomiting.
• Tiredness that can last for a few days with no explanation.

What causes a silent heart attack?

A quiet heart attack is usually the result of coronary artery disease. Cholesterol-containing plaque builds up in your coronary arteries, reducing the amount of blood that can reach your heart muscle. Oxygen-rich blood may not pass through the plaque at all if a blood clot forms on it. Heart muscle can perish if treatment is delayed to restore blood flow.

What are the risk factors for a silent heart attack?

Other health issues can put you at a higher risk for a heart attack. These include:

• Having overweight (a BMI, or body mass index, of 25 or more).
• Not getting regular physical activity.
• Having high blood pressure.
• Having high cholesterol.
• Eating a lot of foods that have cholesterol, salt and unhealthy fats in them.
• Having high blood sugar.
• Feeling stressed.
• Using tobacco products.
• Having preeclampsia during pregnancy.
• Having COVID-19 or another infection.

Some things put you at a higher risk of a heart attack, but you can’t change them. These include:

• Having a history of heart disease in your biological family.
• Being Native American, Mexican American, Black or native Hawaiian.
• Being a man older than 45.
• Being a woman who’s postmenopausal or older than 55.

What are the complications of a silent heart attack?

Waiting too long to get care for a heart attack puts a person at danger of suffering serious cardiac damage and possibly dying.

Heart failure or irregular heart rhythms can result from silent heart attacks. Researchers have also discovered a connection between ischemic strokes and quiet heart attacks.

How is a silent heart attack diagnosed?

During a physical exam, your healthcare provider may find that you have these signs of a silent heart attack:

• A fast or uneven pulse.
• Unusual sounds in your lungs.

What tests will be done to diagnose a silent heart attack?

You may not realize you’ve had a silent heart attack. This is why healthcare providers often diagnose a silent heart attack weeks or months later by:

• Blood tests.
• Electrocardiogram (ECG/EKG).
• Cardiac catheterization with coronary angiography.
• CT scan (computed tomography scan).
• Magnetic resonance imaging (MRI).
• Exercise stress test.
• Nuclear stress test.
• Echocardiogram (echo).