Silent heart attack

Silent heart attack symptoms

By definition, a silent heart attack occurs when you do not have any symptoms from your heart attack. However, it is difficult to distinguish between completely silent heart attacks and atypical heart attack symptoms you may have ignored. A silent heart attack is usually diagnosed after the fact and it may not be possible to determine when the actual heart attack happened. A silent heart attack is detected on an EKG(electrocardiogram, also called ECG) as a specific finding called “Q wave.” When you get a routine ECG done for some other reason and they see this Q wave, they ask you if you had a heart attack in the past. If you do not recall having any heart attack symptoms in the past, you probably had a silent heart attack. However, it is also possible that you may have had some atypical heart attack symptoms in the past that you ignored and did not seek medical attention. If the silent heart attack symptom was a minor discomfort, you may have completely forgotten about it.

Silent heart attack due to atypical heart attack symptoms you may have ignored

Strictly speaking silent heart attack does not have any symptom. However, you may be diagnosed with a silent heart attack if you had unknowing ignored one of the following atypical symptoms and did not know you had a heart attack:

  1. Chest discomfort: You may have had a vague discomfort in your chest that was not severe enough to characterize as pain. It could have been a slight uneasiness or tightness that you did not pay any particular attention to.
  2. Nausea: You may have felt somewhat nauseated for a while without any obvious reason.
  3. Sweating: You may have had an unexplained episode of sweating profusely for a while.
  4. Feeling tired: You may have felt extremely tired and exhausted for a few hours.
  5. A little lightheadedness: You may have had an epidote of mild dizziness or lightheadedness for a few hours that went away on its own.
  6. Heartburn: You may have had an episode of bad heartburn lasting a few hours
  7. Chocking sensation: You may have had an unexplained choking sensation lasting a few hours

This list only gives you some examples of atypical heart attack symptoms that eventually result in the diagnosis of a silent heart attack when you ignore them. For a full list of atypical heart attack symptoms, please refer to this comprehensive article about heart attack symptoms.

Consequences of a silent heart attack:

A silent heart attack occurs when part of your heart muscles die from a lack of blood supply. A silent heart attack may not have any recognizable symptom but it will have consequences similar to regular heart attacks. In fact, silent heart attacks can be more detrimental to your heart because of the missed opportunity to get urgent heart muscle saving treatment. When you have symptoms from a regular heart attack, you seek medical attention immediately. Due to the advancement in heart attack treatments in the last decade, your doctors are usually able to restore blood flow to your dying heart muscles before there is significant permanent damage. However, part of your heart muscle is already dead by the time you are diagnosed with a silent heart attack. Silent heart attack prognosis may be worse than the prognosis of overt heart attack for this reason.

Silent heart attack reasons:

A silent heart attack occurs when you have risk factors for heart disease. A significant number of silent heart attacks happen because of lack of patient awareness about atypical heart attack symptoms. However, some patients have issues with nerves in the chest that result in blunted symptoms of heart attack or they may lead to completely silent heart attacks. Here are some specific risk factors for having truly silent heart attacks.



  1. Diabetes: Patients with type 2 diabetes experience significantly higher proportion of silent heart attacks than any other group of patients. The exact reason for silent heart attacks in diabetics is unclear but it is thought to be secondary to nerve damage from high blood sugars. Diabetics are known to develop a condition called diabetic neuropathy that usually cause pain, numbness and tingling in hands or feet. However, diabetes can also affect heart nerves that can result in blunted or completely masked symptoms during a heart attack.
  2. Certain nerve diseases: Certain diseases of the nervous system such as Parkinson’s disease can directly affect your autonomic nervous system. The nerve supply of your heart is part of this autonomic nervous system. The patients suffering form these nerve diseases are more likely to have few or no symptom from a heart attack.
  3. People with advanced age: Elderly people usually have more silent heart attacks than younger people. The exact reason for this in unclear but it could be related to overall slowing and decreased responsiveness of the nervous system in the elderly.
  4. Women: It is a known fact that women usually have more atypical symptoms of a heart attack than men do. It is, therefore, not surprising that more women are diagnosed with silent heart attacks than men. It is important to raise awareness of this fact to recognize atypical heart attack symptoms in women and avoid getting diagnosed with silent heart attack.

Silent heart attack treatment:

The treatment of a silent heart attack is difficult because a silent heart attack occurs when you miss the window of opportunity when it could be treated. However, there are certain steps you can take to prevent bad outcomes.

  1. Be vigilant for atypical heart attack symptoms: If you have any symptom that makes you think about a possible heart attack, do not hesitate to seek immediate medical attention.
  2. Treat high blood pressure: High blood pressure is one of the most important risk factors for all heart attacks. By treating your high blood pressure, you can significantly reduce your chances of all heart attacks including silent heart attacks.
  3. Blood sugar control for diabetics: If you have diabetes, a tight control of your blood sugar reduces your risks of all cardiovascular events including silent heart attacks.
  4. Quit smoking: Smoking is one of the biggest risk factors for all heart diseases. You can greatly reduce your risk of getting a silent heart attack by getting rid of this unhealthy habit.
  5. Get your cholesterol checked: A bad cholesterol profile along with other risk factors significantly increases your risk for silent heart attack. You need to get your cholesterol levels analyzed and reviewed by your doctor. If you follow the treatment guidelines and control your cholesterol in accordance with your cardiovascular risk profile, you can reduce your chances of having a silent heart attack.
  6. Listen to your body: This is the most important advice for proper and timely diagnosis of any life threatening condition. When you have any symptom that feels very unusual to you and the diagnosis you get does not fit what you are feeling, do not hesitate to tell your doctor about it. You may uncover a silent heart attack otherwise being diagnosed as a heartburn or shoulder strain or upset stomach.