Silent Heart Attacks – Are You At Risk?

Katharine French, MD
Silent Heart Attack

What is a silent heart attack?

Symptoms of a heart attack are classically described as centralized chest pressure, often associated with shortness of breath, sweating, and nausea. Heart attacks can, however, present with atypical symptoms or no symptoms at all. When heart attack symptoms are atypical, they often take longer to recognize by both patients and treating physicians, which can result in delays in seeking medical care, diagnosis and treatment.

Who is at risk for a silent heart attack?

Groups at higher risk of silent heart attacks include women and individuals with diabetes. In a 2008 study of over 500 women who had suffered a heart attack, 43 percent reported no chest pain symptoms (McSweeney, Circulation 2003). Women are more likely than men to present with atypical symptoms of a heart attack which can include shortness of breath, weakness and fatigue.

Diabetes is a disease that affects multiple systems in the body, including the nervous system. In the setting of a heart attack, it is the nervous system that is responsible for triggering the sensation of chest pain. If the nervous system is damaged by diabetes, a heart attack may not trigger the classic chest pain response and therefore may be silent and go unnoticed.

What are the symptoms of a silent heart attack?

Implied in the name, a silent heart attack can be just that – silent – or without any symptoms. Yet most people who have been diagnosed with a “silent heart attack” are able to look back and identify atypical symptoms that they either ignored or attributed to other conditions.

Atypical symptoms of a heart attack may include:

  • shortness of breath
  • pain in locations other than the chest (arms, neck, jaw, back, upper abdomen)
  • fatigue/weakness
  • lightheadedness
  • nausea/vomiting
  • indigestion
  • sweating

What can you do to lower your risk of a silent heart attack?

Taking steps to lower your risk of heart disease will also lower your risk of having a silent heart attack. These include lifestyle measures such as getting regular exercise, eating a heart-healthy diet and not smoking. Regular follow-up with your doctors is also important to make sure your blood pressure, cholesterol and blood sugar are well-controlled.

Because “silent” heart attacks are often not truly silent, it is important to be familiar with atypical symptoms of heart attacks, particularly if you are a woman or have diabetes. If you experience any of these symptoms and suspect something is not right, listen to your body and seek medical care right away.

For more information on heart health, visit our website.

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