A healthy living blog from Marshfield Clinic

Quiet killers: Silent heart attacks may have deafening consequences

Silent Heart Attack illustration

While silent heart attacks have no obvious symptoms, their consequences can be serious.

Most often, heart attacks come with warning signs, like shortness of breath, chest pain, indigestion or discomfort in the neck, left arm or jaw. With silent heart attacks, no such symptoms appear.

Marshfield Clinic cardiologist Dr. Shereif Rezkalla said that often, particularly in individuals with diabetes, which can impact nerve function, silent heart attack sufferers feel no symptoms at all. Other times, “they may experience very mild symptoms both the patient and the doctor may miss,” Rezkalla said.

A heart attack occurs when blood is prevented from reaching part of the heart muscle because of a blockage in the coronary artery, which results in damage or death of that muscle. Typically, a heart attack, from the moment the artery is blocked to its conclusion, lasts about six hours, Rezkalla said.

“That’s why we always say ‘time is money.’ Actually, in cardiology, we always say time is myocardium, which is the muscle tissue of the heart,” Rezkalla said. “Early intervention with heart attacks is key.”

About one-third of all heart attacks are silent, according to Rezkalla.

Silent but just as dangerous

Silent heart attacks impact a patient’s health in the same way and with the same severity as a heart attack that presents symptoms.

“The impact depends on how big the heart muscle is that died or is scarred,” Rezkalla said. “If it’s a large muscle, then it is a significant impact. If it’s a small muscle, it’s a smaller impact.”

Rezkalla said he worries more about silent heart attacks than heart attacks with symptoms.

I personally think silent heart attacks are more serious. Anything that happens without any warning, without any symptom to push you to go to the hospital or to your doctor, is serious,” Rezkalla said.

“If you feel nothing, the damage will be done at home instead of having your situation managed by your doctor.”

How silent heart attacks are detected

Silent heart attack sufferers generally won’t know they have suffered an attack until they see their doctor and have an electrocardiogram. However, if the silent heart attack was severe, individuals may begin to experience shortness of breath after the incident.

With today’s technology, doctors at Marshfield Clinic can monitor a patient’s heart activity while they’re at home. This allows for detection of silent heart attacks, even if the patient never notices symptoms.

Risk factors

Rezkalla said individuals at higher risk for heart attacks, silent or not, include people who:

High levels of LDL cholesterol can lead to plaque forming on the walls of arteries, which can create blockages within those arteries.

Prevention of heart attacks, silent or otherwise

“There are things all of us as human beings must do, whether or not we have a family history of heart disease, whether or not we are young or old,” Rezkalla said. He recommends daily exercise, a healthy diet and not smoking as key factors in maintaining good heart health.

Talk with your doctor about your risk factors and steps you can take to promote a healthier heart.

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