Silent Heart Attack

Last reviewed by Dr.Mary on November 30th, 2011.

What is a Silent Heart Attack?

Have you ever experienced a heart attack? What symptoms did you experience then? Did it include chest pains? This is just one of the clinical manifestations of a typical heart attack. However, there’s another condition termed as silent heart attack. More often than not, a silent heart attack is considerably more dangerous than a heart attack which has manifestations such as chest pains.

The American Journal of Cardiology conducted a study in January of 2009 and it involved over 6,000 subjects including both men and women whose ages fall above 65. About 901 of the total study participants were subjected to an electrocardiogram and it was found out that nearly one-fifth of them do not recognize that they have already experienced a heart attack not until the study was conducted. This proves it that silent heart attack is more fatal than the typical ones because not even the patient knows about it.

There are actually two types of silent heart attack. The first one involved a silent heart attack that does not seem to evoke even a single symptom at all, as the name suggests. The second one involves faint symptoms which seem to be unrecognizable on the part of the patient. At times, the heart attack may just be too mild that the patient would just ignore it because it does not resemble a heart attack at all. This is the danger of a silent heart attack. Certainly, most of the silent heart attack cases went untreated because the patients did not complain of any. Because of this, the damage becomes more extensive and the next time a heart attack is triggered, this can be a more fatal one. Thus, it is imperative that you seek medical help as you age even when you do not feel anything unusual especial involving the heart.

Silent Heart Attack Symptoms

Generally, a silent heart attack does not seem to elicit any symptoms. However, the following hints would be helpful in telling you that you are already experiencing a heart attack. Take note that you may be able to experience the following symptoms but these are too vague for you to notice. Thus, you have to be twice as keen so you would be able to distinguish normal from what is not. A silent heart attack would most likely include the following symptoms:

  • Chest pain- This is considered as the defining characteristic of a heart attack. However, in cases of a silent heart attack, the chest pain may be too faint that you wouldn’t even be able to notice it.
  • Sudden feeling of indigestion or heart burn
  • Dizziness
  • Weakness
  • Nausea and vomiting
  • Profuse sweating
  • Sudden fatigue
  • Sudden loss of consciousness

When you experience the previously mentioned symptoms, it is likely that you are suffering from a silent heart attack. Do not ever hesitate to seek medical help whenever you noted one or more of these symptoms so as not to compound the damage. Furthermore, you could suspect that you are suffering from a silent heart attack when you have existing conditions which include:

  • Diabetes
  • Excessive alcohol consumption
  • High cholesterol levels
  • Family history of hypertension and other cardiovascular diseases
  • Obesity
  • Sedentary lifestyle
  • Smoking cigars and tobacco

Silent Heart Attack Causes

A silent heart attack is also referred to as silent ischemia. This primarily takes place when the oxygen supply to the heart is depleted. There can also be several factors why the oxygen circulation to the heart is diminished. The number one reason for that can be due to obstruction in the coronary arteries. Anatomically speaking, your coronary arteries bring oxygenated blood towards the heart and when there’s blockage at this specific site, it is likely that a heart attack would take place, whether it is a silent one or not. Gradual plaque deposition within the coronary arteries due to high levels of cholesterol is likely to cause obstruction then a heart attack. It is also important to consider that a heart attack may happen almost anytime. It can happen just when:

  • You are sleeping
  • You engage in physical activities
  • You expose yourself in cold temperatures
  • You are experiencing sudden emotional stress, especially during an illness


A silent heart attack is utterly a fatal condition and is considered a medical emergency. If this is just being left untreated, chances are, the damages may be twice as much the next time it strikes. Aside from that, do not also wait for the heart attack to trigger a cardiogenic shock. This primarily takes place when the damage to the heart has been too much disabling it to pump blood and oxygen to the different parts of the body. This is why early detection is an important factor in a silent heart attack. You will only be able to tell that you are suffering from a silent heart attack through an electrocardiogram. An electrocardiogram would be able to detect the electrical activities of your heart. This especially detects for the presence of any abnormalities in electrical conduction. A thorough medical history-taking also aids in the detection of a silent heart attack. A physical stress may also be conducted to diagnose a possible heart attack.

Silent Heart Attack Treatment

This condition is entirely a medical emergency. You cannot just stay at home any further and delay treatment. By all means, when you suspect that you or someone other than yourself is suffering from a silent heart attack, you should right away go to the nearest hospital so that first aid treatments may be given. Soon as you arrive in the emergency department, you will be given the following treatments:

  • Initially, you will be put under intensive oxygen therapy so as not to overwork your heart.
  • You will also be hooked to a cardiac monitor to be certain of your heart’s status from time to time.
  • In some instances, you may also be given aspirin. This medication is believed to lessen the detrimental effects of a heart attack.
  • A venoclysis would also be right away started so it would be easier to access the veins for intravenous (IV) medications.
  • Medications like nitroglycerine and morphine may also be given to relieve chest pain.
  • You will also be continuously watched for cardiac arrhythmias because these are the leading cause of death in patients with heart problems. Usually, this can be corrected through medications or perhaps a cardioversion.

Furthermore, this may also be treated with the following:

Coronary Angioplasty

This is almost all the time indicated for patients who suffer from a heart attack. This procedure is right away performed once you are admitted at the hospital, typically from around 90 minutes after hospital confinement. However, this is not anymore indicated when it is already past 12 hours after the heart attack. In this procedure, a small, metal tube in inserted into the artery to open up the blockage. A stent, which can also be made up of small, metal mesh tube may also be temporarily placed in the artery so as to prevent further obstruction.


These medications may also be given after the procedure to deter the formation of blood clots. It is suggested that these drugs are given within the first 3 hours since the pain was felt. This is also otherwise known as thrombolytic therapy.

Heart Bypass

Depending on the extensiveness of the damage, a bypass surgery may be indicated to some patients. This is also done for the same purpose, to evacuate the clots and blockage in the coronary artery. This also goes by the name open heart surgery.

Silent Heart Attack Prognosis

The earlier the condition is detected, the better the chance of recovery is owing to the fact that an untreated silent heart attack could double its detrimental effects to the body. Once your condition has been detected, you will most likely have the following medications as your maintenance drugs:

Thrombolytic agents

These medications are also known as blood thinners which keep blood from aggregating. These include aspirin, clopidogrel, warfarin, among others.

ACE Inhibitors and Beta-Blockers

Additionally, these drugs may also be given to protect the heart.


So as to control your cholesterol levels, these may also be indicated.

Compliance with the treatment plan is of prime significance in the process of recovery. It could also be that you will be taking the above mentioned medications through your entire existence. Frequent visits to your doctor are also important so as to evaluate your condition. Most importantly, do not stop the following medications without the order of your physician. Aside from that, it is also equally important to observe a healthy lifestyle following a heart attack.

  • First off, it is very important that you learn how to control your cholesterol and blood sugar levels and as well as your blood pressure.
  • Apart from that, you should also gradually exercise to keep your heart in good condition. It is suggested that you indulge into an exercise routine at least 30 minutes a day, 5 days within a week. However, you should discuss this option with your doctor first.
  • Do not also forget to include healthy foods in your meals such as foods, vegetables, lean meats and whole grains.
  • It is also imperative that you avoid vices such as smoking and alcohol consumption.
  • Most importantly, make it a goal that you maintain the ideal weight. The ideal body mass index (BMI) is between 18.5 and 24.9.

How you will recover following a silent heart attack entirely depends on several factors. This may generally depend on the location of the damage and the capacity of the heart valves to contract. Chances are, once you already have a history of heart attack, it is likely that you will get another one. Thus, it is vital that you comply with the treatment plan and observe a healthy way of living.

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