The term “silent heart attack” describes the condition in which evidence of a prior heart attack is picked up during medical testing in a patient who did not understand that they have had a heart attack. Many people do not experience the typical chest discomfort that most people think of when they imagine what is like to have a heart attack, and this is how these heart attacks can be missed. For example, we know that patients with diabetes are at higher risk for heart disease, but they are also more likely to experience atypical chest pain or no chest pain at all when having a heart attack.
Silent heart attacks have real consequences, and we are learning to take them just as seriously as heart attacks that manifest with traditional symptoms.
What are the symptoms?
Patients don’t experience symptoms during a silent heart attack. However, patients might feel the after-effects of the damage from a heart attack, mainly symptoms of heart failure that can include:
Common heart attack signs and symptoms include:
- Cold sweat.
- Lightheadedness or sudden dizziness.
- Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back.
- Nausea, indigestion, heartburn or abdominal pain.
- Shortness of breath.
Are the symptoms different for men than women?
We are still learning about the differences between men and women with respect to heart attacks, but while all patients can experience atypical symptoms, women—particularly young women—may be less likely to experience traditional symptoms and therefore may not know that they are having a heart attack. It is essential for both patients and doctors to consider the possibility of a heart attack in patients, especially those who have risk factors for heart disease.
What can cause a silent heart attack? Are the causes different for men than women?
The causes of silent heart attacks are the same as those that cause heart attacks with symptoms. The most general cause of a heart attack is a blockage in a blood vessel that compromises the blood supply to the portion of the heart that depends on that blood vessel. However, there are many different ways that blood flow to the heart can be compromised and women may be at higher risk for some of the less common mechanisms, which include:
- Spontaneous coronary artery dissection or SCAD
- Coronary vasospasm
- Microvascular disease
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