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Silent heart attack: Warning signs and symptoms not to be missed and what to do next
Published On: Thu, Oct 11th, 2018

Silent heart attack: Warning signs and symptoms not to be missed and what to do next


Silent heart attack is known as a silent myocardial infarction (SMI) by medical professionals and is believed to account for around half of all heart attacks.

The problem with SMI is it’s often mistaken for less serious conditions because of the nature of symptoms.

The symptoms can feel mild, lacking the intensity of classic heart attack signs such as extreme chest pain, tightness, pressure and stabbing pain in the arm, neck or jaw.

The three warning signs to note include mild pain or discomfort in the throat, mild pain in the centre of the chest, and the location of the pain.

The location of pain is sometimes misunderstood. You may feel discomfort in the centre of the chest and not a sharp pain on the left side of the chest, which many people associate with a heart attack, Dr Jorge Plutzky told Harvard Health Publishing.

He added: ”SMI symptoms can feel so mild, and be so brief, they often get confused for regular discomfort or another less serious problem.”

While symptoms are not as noticeable as a heart attack, SMIs can increase the risk of coronary heart disease, which can prove fatal.

Harvard cites a study of 2,000 people who initially didn’t have heart problems. Ten years later, eight percent of the subjects had myocardial scars, which proved they had suffered an attack.

Incredibly, 80 percent of those people were unaware they’d had any kind of heart issue.

Silent heart attacks are particularly dangerous because sufferers don’t seek medical treatment afterwards.

Dr Plutzky added: “SMI often leaves scarring and damage to the heart, which, combined with the fact that many people who have an SMI don’t seek immediate care, can further raise a person’s risk of a second and potentially more harmful heart attack.”

While Harvard Health says silent heart attacks strike men more than women, a Norwegian study found silent heart attacks happen more in women, because women’s pain threshold is higher, making them less likely to realise they are having an attack.

The researchers had 4,000 adults place their hand in ice-cold water for as long as possible to ascertain their pain threshold.

Those who had had a silent heart attack – eight percent of participants – kept their hand in the water for much longer than the 4.7 percent of participants who’d had a heart attack and recognised the pain.

While female participants had experienced less heart attacks than men, a large proportion of those were silent – 75 percent compared to 58 percent in men.

British Heart Foundation’s Associate Medical Director, Dr Mike Knapton, said more needs to be done to help understand what was causing people to miss the signs of a heart attack.

“Silent heart attack is a major problem in the UK. It is worryingly common for patients to visit their GP having already had a heart attack but they are completely unaware of it.

“Pain threshold may well be the reason for some people not noticing the symptoms of a heart attack, but more research needs to be done to help us understand what’s causing others to miss the signs,” he said.

“Despite coronary heart disease killing more than twice as many women than breast cancer, we know that women often don’t realise they can be at risk. This makes them more likely to ignore the symptoms and delay getting help.”

Heart attack symptoms can be associated with those of less serious health conditions, but if you suspect any of these signs, you should dial 999 immediately. 



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Silent heart attack: Warning signs and symptoms not to be missed and what to do next