Medically reviewed on February 24, 2023 by Karen L. Janson, MS, MD. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
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When you think of a heart attack, you may envision someone clutching their chest, gasping for air, and collapsing to the ground. While some heart attacks present this way, not all of them do. In fact, some heart attacks go almost entirely undetected.
So, can you have a heart attack and not know it? Yes, you can. Silent heart attacks, also known as silent myocardial infarctions (SMIs), may only have mild symptoms if any at all. It’s estimated that around 45% of all heart attacks fall into this category .
Below, we’ll highlight the potential symptoms of a silent heart attack. We’ll also explain how you can find out if you’ve experienced a silent heart attack in the past.
A heart attack occurs when one or more of your coronary arteries becomes clogged and partially or completely cuts off blood flow to your heart. The portions of your heart that do not receive blood flow are starved of oxygen and begin to die, leaving your heart muscle damaged and scarred .
The longer your heart goes without adequate oxygen, the more heart muscle damage can occur. Irreversible damage can occur in as little as 30 minutes . As a result, it’s crucial for anyone experiencing a heart attack to receive immediate medical attention. In many cases, it can make the difference between life and death.
Unfortunately, if you don’t realize you’re having a heart attack, you may not call 911 and receive the prompt medical attention and early heart attack care you require. That’s why understanding the subtle signs of silent heart attacks is so important.
Since silent heart attacks may have a milder or shorter duration of symptoms, you may assume they’re less harmful to your health. However, this could not be further from the truth.
To deepen your understanding, let’s explore some statistics and research findings that display the prevalence and danger of silent heart attacks:
Since people who experience silent heart attacks aren’t aware of their health predicament, they may never seek medical treatment or make the necessary lifestyle changes to prevent more severe heart issues going forward.
Silent heart attacks can be hard to detect because their symptoms are often milder than those of classic heart attacks. Some people may not have any obvious symptoms at all.
Classic heart attacks are often accompanied by :
Instead, silent heart attack symptoms may more closely resemble heartburn, indigestion, or acid reflux. Silent heart attack symptoms can include :
Note: Women are more likely than men to experience heart attack symptoms other than chest pain. These symptoms include arm, neck, or upper abdominal discomfort, shortness of breath, lightheadedness, fatigue, nausea, and/or sweating. In fact, these symptoms may be more noticeable than any chest discomfort making a silent heart attack more difficult to recognize .
Therefore, many people experiencing silent heart attacks simply ignore these symptoms and wait for them to go away. In turn, they may not get the immediate medical care they need to save their heart health. This is why silent heart attacks can be even more dangerous than obvious ones, despite their milder symptoms.
The risk factors for regular heart attacks and silent heart attacks are the same. They include :
Since a history of heart attack is associated with an increased risk of having another one, it may be’s important to find out if you’ve had a silent heart attack in the past.
Silent heart attacks don’t always have clear symptoms. An electrocardiogram (abbreviated ECG or EKG) or an exercise stress test can help determine if your heart muscle has been injured.
ECGs are tests that record your heart’s electrical signals. ECGs can show if your heart has any muscle damage. Abnormal test results may indicate that you’ve had a silent heart attack in the past . Your healthcare provider may order an ECG if you report:
Since the symptoms of heart disease can come and go, your healthcare provider may even recommend that you use a continuous ECG monitor. These wearable devices can record your heart’s electrical activity continuously or exclusively during a symptomatic event.
Stress tests evaluate how the heart functions during exercise. During a stress test, monitors track your heart rate, heart rhythm, breathing, and blood pressure as you ride a stationary bike or walk on a treadmill. These tests can uncover issues with your heart’s blood flow or rhythm that may be due to a silent heart attack .
If you suspect you may have had a silent heart attack, you may want to ask your healthcare provider about these tests. When it comes to your heart health, it's much better to be safe than sorry.
The treatment protocol for a silent heart attack may include :
Additionally, your healthcare provider may recommend you make changes to your diet, such as reducing your intake of processed foods and saturated fats. Your provider may also encourage you to incorporate exercise to lower cholesterol, and quit smoking. These heart-healthy habits could help protect you from future health problems.
If you get checked out and discover you haven’t experienced a silent heart attack, that’s fantastic news. To take a proactive posture, you can reduce your chances of ever having one by :
These preventative practices can also protect you from a host of other health issues.
After sending in your finger-prick blood sample, we’ll have it tested at a CLIA-certified laboratory and reviewed by an independent board-certified physician in your state. We’ll then send your results with easy-to-understand explanations of what they mean. These test results can shed light on your current risks for heart disease and diabetes.