Silent Heart Attack

Overview

What is a silent heart attack?

A heart attack is called “silent” when it has no symptoms, mild symptoms or symptoms people don’t connect to a heart attack. Also known as a myocardial infarction, a heart attack means your heart isn’t getting oxygen. This injures your heart. 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 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.
  • You’re physically active outside in the cold.

Who does a silent heart attack affect? 

Silent heart attacks may be more common in women.

How common is a silent heart attack?

Some estimate that nearly 50% to 80% of all heart attacks are silent.

How does a silent heart attack affect your body?

A silent heart attack can injure your heart just like a more obvious heart attack that doesn’t allow oxygen to get to part of your heart. But if you don’t know you’re having a heart attack, you may not get the medical help you need to limit the damage. A silent heart attack has been linked to a higher risk of heart failure.

Symptoms and Causes

What are the symptoms of a silent heart attack?

People who have a silent heart attack have symptoms not normally associated with a heart attack, mild symptoms or no symptoms at all. They may not realize they’ve had a heart attack.

With a silent heart attack, symptoms 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 are 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.
  • Discomfort in your upper body.
  • Lightheadedness.
  • Cold sweats.
  • Nausea and vomiting.
  • Tiredness that can last for a few days with no explanation.

How do I know if I’m having a heart attack or angina?

People with ischemic heart disease can get chest pain when they’re moving around. This pain stops after a few minutes of rest. You could be having a heart attack if the chest pain doesn’t go away.

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:

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 family.
  • Having preeclampsia during pregnancy.
  • Being Native American, Mexican American, Black or native Hawaiian.
  • Being older than 45 (males).
  • Being postmenopausal or older than 55 (females).
  • Being infected with COVID-19.

What causes a silent heart attack?

Plaque that contains cholesterol collects in your coronary arteries. When a blood clot forms on the plaque, it keeps oxygen-rich blood from getting through to your heart muscle.

Diagnosis and Tests

How is a silent heart attack diagnosed?

Your healthcare provider may find that you have:

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

What tests can help diagnose a silent heart attack?

Often, a silent heart attack is diagnosed weeks or months later by:

Management and Treatment

How is a silent heart attack treated?

Unfortunately, many people don’t even realize they’re having a silent heart attack because they’re not having obvious symptoms. But a heart attack of any kind is an emergency. You should call 911 right away even if you don’t know for sure that you’re having a heart attack.

A 911 operator can tell you if you should take an aspirin. Paramedics can give you medication while you’re in the ambulance.

At the hospital, your healthcare provider will:

  • Monitor your heart.
  • Give you oxygen.
  • Give you medicine for pain and to break up or prevent blood clots.

As soon as possible, your provider may do a coronary angioplasty to open a blood vessel that got too narrow or clogged. A stent can be put inside the blood vessel to keep it open so blood can flow through. In some cases, you may need a coronary artery bypass graft to create a way for blood to go around the clogged area.

How do I take care of myself after a silent heart attack?

After you go home from the hospital, you’ll need to keep taking the medicines your provider ordered for you. It’s important that you keep taking these medications. Some may be necessary for the rest of your life.

Types of medications may include:

  • Beta blockers.
  • Anticoagulants.
  • Anticlotting medications.
  • Fish oil.
  • Statins.
  • ACE inhibitors.

You may feel tired, sad and anxious after having a heart attack. Your emotions should go back to normal in two or three weeks. Some people find it helpful to join a support group where they can talk with others who’ve been through a similar experience.

Prevention

How can I reduce my risk of a silent heart attack?

Taking aspirin may prevent a heart attack, but be sure to check with your provider before you start taking it. Other things you can do to help prevent a heart attack include:

  • Exercise.
  • Stop use of tobacco products.
  • Eat healthy foods.
  • Keep your stress under control.
  • Stay at a healthy weight.

If you have medical problems that can increase your risk of a heart attack, taking care of those problems can help prevent a heart attack.

These medical problems include:

Unfortunately, it’s possible to have another heart attack once you’ve already had one. This is why it’s important to keep taking your medications and follow your provider’s instructions. Cardiac rehabilitation, which combines education and exercise, can be helpful as well.

Outlook / Prognosis

What can I expect if I have a silent heart attack?

Everyone’s experience is a bit different based on how much their heart attack hurt their heart, but most people can get back to doing regular things little by little and have active lives. 

Some people can get abnormal heart rhythms or heart failure, which can be serious. People who wait too long to get help for a heart attack run the risk of severe damage to their hearts and may not survive if they don’t get help soon enough.

Living With

How do I take care of myself long-term after a silent heart attack?

After a heart attack, you may need to make some changes in your life, such as:

  • Eating a diet that’s good for your heart.
  • Being active.
  • Quitting tobacco use.
  • Staying at a healthy weight.

You should also follow your provider’s instructions and keep taking medicines they ordered for you. And it’s important to have regular checkups with your healthcare provider. In some cases, your provider may want to do another electrocardiogram.

What questions should I ask my doctor?

  • How concerned should I be about having another heart attack?
  • How successful are the treatments for a heart attack?
  • What’s the most important thing I can do to prevent a silent heart attack?

A note from Cleveland Clinic

You may not even know you’ve had a silent heart attack until weeks or months after it happens. It’s best to know what’s normal for your body and get help when something doesn’t feel right. Knowing the subtle signs of a silent heart attack can help you identify one. Be sure to get regular checkups with your healthcare provider. You can also help yourself by treating medical problems that can lead to a heart attack. Switching to a healthier diet and adding exercise can help as well.

Last reviewed by a Cleveland Clinic medical professional on 07/28/2021.

References

  • MedlinePlus. Heart attack. (https://medlineplus.gov/ency/article/000195.htm) Accessed 6/22/2021.
  • National Heart, Lung, and Blood Institute. Heart Attack. (https://www.nhlbi.nih.gov/health-topics/heart-attack) Accessed 6/22/2021.
  • American Heart Association. What is a Silent Heart Attack? (https://www.goredforwomen.org/en/about-heart-disease-in-women/signs-and-symptoms-in-women/silent-heart-attack-symptoms-risks) Accessed 6/23/2021.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy