What is a Silent Heart Attack?

A silent heart attack—also known as a silent myocardial infarction—is a type of heart attack that often goes unrecognized. That’s because its symptoms are mild enough to be nearly undetectable by a person. 

“More typical heart attacks come with a host of well-known and sometimes dramatic symptoms,” says Haroon Faraz, M.D., interventional cardiologist at Palisades Medical Center and Hackensack University Medical Center. “Silent heart attack symptoms lack this intensity and can be mistaken for a minor chest discomfort, indigestion or other less serious problems.”

Silent Heart Attacks vs. Typical Heart Attacks

“Silent heart attacks involve blockage of blood flow to the heart and damage to the muscle,” says Saleem Husain, M.D., interventional cardiologist at JFK University Medical Center. “In this sense, they are no different from any other heart attack. Their differences lie in how they manifest through noticeable symptoms.” 

Typical heart attack symptoms include:

• Pain in the back or belly
• Stabbing sensation in the left arm, neck, jaw or teeth
• Sudden shortness of breath
• Sweating
• Dizziness or lightheadedness
• Nausea or vomiting

Symptoms of silent heart attacks are much more subtle—if they exist at all:

• Feeling as if you have a sore or strained muscle in your chest or upper back
• Fatigue or stress
• Indigestion
• Flu-like symptoms
• Discomfort that doesn’t go away when you move around 

Risk Factors of a Silent Heart Attack

Silent heart attacks account for about 20 percent of all heart attacks, according to 2022 data from the American Heart Association. Risks of any heart attack include:

• Being overweight or obese
• Lack of exercise
• A diet high in cholesterol, salt and unhealthy fats
• High blood pressure
• High cholesterol
• Tobacco use
• High stress 

“Identifying and treating risk factors is crucial to reducing the chance of having another heart attack,” says Dr. Husain.

Additionally, certain genetic factors increase your risk of heart attack. “Cardiovascular risk, in general, can be inherited from one generation to the next,” Dr. Faraz says. “If your parent or sibling is affected by a heart attack, your risk is increased.”

How to Tell if You’ve Had a Silent Heart Attack

Only an imaging test, such as an electrocardiogram (ECG), echocardiogram or CT scan, can identify a silent heart attack. “An ECG can show where the heart muscle is damaged,” says Dr. Husain. 

A heart attack of any kind is an emergency. Even if you aren’t confident that you’re having a heart attack, it’s important to call 911 right away.

Next Steps and Resources:

• Meet our sources: Haroon Faraz, M.D., and Saleem Husain, M.D.
• To make an appointment with a cardiologist near you, call 800-822-8905 or visit our website.
• Are you at risk for a heart attack? Take our quiz
• Schedule a heart screening near you