‘Silent’ Heart Attacks: Vital Facts on Symptoms and Prevention

Nearly half of all heart attacks may be “silent” – occurring without any symptoms or with symptoms that are mistaken for less serious health issues – according to research published by the American Heart Association.

They are often referred to as “silent heart attacks” because they lack the traditional signs of a cardiac event, such as extreme chest pain or pressure; stabbing pain in the arm, neck, or jaw — or even shortness of breath.

“Unlike heart attacks that present with classic squeezing chest pain, or with radiation to the arm or jaw, they are often asymptomatic or have mild symptoms that are commonly disregarded or ignored,” explains Tarak Rambhatla, M.D., cardiologist with Miami Cardiac & Vascular Institute, part of Baptist Health South Florida. “Patients may just feel overall unwell, a sense of fatigue, or general discomfort. Patients may also even feel well or normal.”

Silent heart attacks can produce symptoms such as indigestion, nausea, muscle pain or even a malaise that resembles a bad case of the flu. “Anyone who feels a change in their normal well-being, such as fatigue, weakness, decrease in exercise tolerance, or new symptoms that are not expected, such as indigestion, heart burn, nausea, or mild discomfort in the chest area, should prompt medical attention,” says Dr. Rambhatla.

It’s especially critical for some individuals to seek medical help if they feel these changes — including patients with risk factors for heart disease, such a diabetes, a family history of heart disease, high cholesterol, high blood pressure, smoking, physical inactivity, obesity, and previously diagnosed heart disease, adds Dr. Rambhatla.

Silent heart attacks occur more commonly in patients with diabetes, older-aged patients, and men, he adds.

Dr. Rambhatla points to the American Heart Association’s “Life’s Simple 7” plan as an effective prevention program to help those at risk for silent heart attacks or heart disease. It covers the seven key areas of prevention: Managing blood pressure, controlling cholesterol, reducing blood sugar, exercising regularly, healthy eating, weight management and not smoking.

“Life’s simple seven tips and tools for leading a heart healthy life are: eating healthy (diet low in bad fat and sugars), increasing physical activity (150 minutes of moderate exercise per week), losing weight, quit smoking, reducing blood sugar, controlling cholesterol, and managing blood pressure,” says Dr. Rambhatla.

He encourages all his patients to follow “Life’s Simple 7” and establish routine care with a physician (primary care doctor or cardiologist).

“The best management is aggressive prevention,” he says. “The goal is to diagnose and intervene early so that we can avoid having to treat patients after the fact — after a patient already suffers a heart attack.”