woman in red holding a model of a heart, looking surprised

Heart Attacks Can Be Silent: Signs to Look Out For

The American Heart Association’s 2022 statistics show that 20% of all heart attacks are subtle, so-called silent heart attacks that don’t produce the chest-tightening pressure and pain often depicted in movies. Some experts suggest that the percentage of silent heart attacks is closer to 50%.

“It has long been known that silent heart attacks, identified on an ECG or ultrasound scan, are quite common,” Dr. Joel Kahn, founder of the Kahn Center for Cardiac Longevity in Michigan, told Newsmax. “Some people can close a heart artery without any symptoms or with atypical symptoms of heartburn or shortness of breath that do not prompt them to go to the emergency room. Nonetheless, silent heart attacks are important and are a reason I check an ECG on every patient I see.

According to AARP, heart attacks occur when the arteries carrying blood to the heart become blocked, depriving the heart muscle of oxygen and nutrients. Dr. Eduardo Marban, an international cardiology leader at Cedars-Sinai Medical Center in Los Angeles, says the blockage can cause pain and pressure during a heart attack. In some people, the symptoms go unnoticed.

“It’s not necessarily that there were no symptoms,” says Marban. “The patient may not have recognized them as cardiac symptoms and was not concerned.” The patient may think they have indigestion, or have a strained muscle, or feel exhausted, Marban explains.

Some people who suffer a silent heart attack may recall feeling short of breath, nauseous or sweaty, dizzy or feeling sick, experts say. Some people really don’t experience any symptoms, perhaps because they have diabetes and have neuropathy that shuts off pain signals. Women and the elderly are also more likely to have a cardiac event without warning signs, the AARP says.

Here are some typical and non-classic symptoms of a silent heart attack, according to Harvard Medical School:

  • Shortness of breath
  • Weakness
  • Nausea or vomiting
  • Dizziness
  • Back or jaw pain
  • Unexplained tiredness

These symptoms can be misdiagnosed even in healthcare facilities. Dr. Robert Lager, a cardiologist at MedStar Washington Hospital Center in Washington, DC, tells AARP that the signs are often confusing and misleading. However, Lager says the symptoms of heart trouble are “not positional.” This means that the pain in your back does not go away when you stretch or move around, and the shortness of breath does not improve when you sit down and rest.

“It’s a very good rule of thumb,” Lager said. “If you’re not sure you have a symptom, see if you can somehow handle it. Can you chest press? Can you switch positions? Can you stand up? or sit? Does it make a difference, positionally? Because the heart doesn’t have a gyroscope; it doesn’t know where it is in space. And it doesn’t matter if you put the heart upside down or on the spot, he will give you the same signals if he is having trouble.

Lager adds that the symptoms will worsen due to the lack of nutrient-rich oxygen in the heart. “So if someone has chest discomfort at rest and gets up and walks around, you’re increasing the oxygen demand of the heart, and the symptoms usually get worse if it’s a heart problem,” he explains.

Drs. Marban and Lager stress that it’s important to be aware of changes in your body, and if symptoms appear out of the blue that are rare, get them checked out. If you’re prone to indigestion, that feeling of chest discomfort after a spicy meal is probably gastrointestinal, but if it’s something you’ve never experienced before, or the symptoms are getting worse , this may be a sign of a silent heart attack.

Even if the damage has already been done, identifying a silent heart attack can help you get treatment to recover faster and prevent future cardiovascular events, such as heart failure, the likelihood of sudden death , stroke or other heart attack.

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