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Understanding the Long-Term Risks of Silent Heart Attacks

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“Silent heart attack” seems like an oxymoron. When you say, “I almost had a heart attack,” you’re not describing a mild reaction. You’re drawing a comparison to the extreme symptoms most people associate with heart attacks – severe chest pain, nausea, shortness of breath, and other signs. But, in reality, almost half of all heart attacks aren’t such intense affairs. You might not even realize you’re having one.

Reviewing imaging results

Silent heart attacks get their name from their lack of severe symptoms. In fact, they may not have any symptoms at all. And while these heart attacks might not be as deadly as their more obvious counterparts, they can still cause permanent damage if left unchecked. For cardiologists like Christopher Dyke, MD, this is why educating patients is so important.

“People are familiar with the classic symptoms you'll read in a textbook, like the feeling of an elephant sitting on your chest,” says Dr. Dyke. “But, unless they’re aware of some of the signs of silent heart attacks, or their own personal risk factors, they may not be able to recognize the danger.”

When the heart is damaged, it doesn’t regenerate. So if you suffer damage from a heart attack, silent or otherwise, you run the risk of permanently weakening your heart.

“Once those cells die, they're gone forever,” said Dr. Dyke. “That portion of heart muscle cannot be reinvigorated. It cannot come back. So patients are often left with serious complications – all the heart failure and other issues that put them at risk over time.”

What’s Behind a Silent Heart Attack? 

The causes of silent heart attacks are just like those of regular heart attacks. Coronary artery disease is the most common cause (Opens in a new window), as it interrupts the blood supply to the heart. However, sudden contractions or spasms of the coronary artery also can lead to a silent heart attack.

There are a variety of factors that can put you at higher risk for silent heart attacks, including:


Signs of a Silent Heart Attack

Silent heart attacks are difficult to detect. Sometimes, people experiencing a silent heart attack may may not have any symptoms. Other times, silent heart attacks can produce mild symptoms such as:

  • The feeling of severe indigestion
  • Left arm pain or numbness
  • Fatigue
  • Soreness in the chest or upper back 
  • An aching sensation in your jaw, arms or upper back

Because symptoms can be difficult to spot, it’s important to talk to your doctor if you feel like you may have experienced a silent heart attack or if you’re at risk.

The evidence of a silent heart attack is usually discovered weeks or months after it’s occurred. In addition to a physical exam and blood test, your doctor may perform scans. Additional tests can help determine if the heart has been damaged from a silent heart attack.

Why Timing Matters

Early detection of silent heart attacks and risk factors is crucial for minimizing the danger of significant heart damage. It’s worth remembering that a silent heart attack can increase your risk for additional heart attacks.

“Diagnosing people who are at risk earlier is important in terms reducing  heart attacks, symptoms from heart attacks and the consequences of heart attacks,” according to Dr. Dyke. “If we can diagnose heart disease earlier, then we can prevent the complications that people suffer after a heart attack.

If you are experiencing a silent heart attack, your doctor may treat you by administering oxygen and providing medication to break up or prevent blood clotting. Continuous use of medications such as beta blockers and anticoagulants may be required after suffering a silent heart attack. To reduce the risk of further heart damage, your doctor may recommend lifestyle adjustments. These can include getting more exercise, eating healthier or quitting smoking.