Harvard Heart Letter

Ask the doctor: What are silent heart attacks?

Ask the doctor

What are silent heart attacks?

Q. What are silent heart attacks? How are they different from regular ones? If they are silent, how does anyone know about them?

A. So-called silent heart attacks are episodes in which part of the heart is damaged when something blocks blood flow through a coronary artery, but the symptoms that accompany the blockage are so subtle that they go unnoticed or are ignored. Silent heart attacks are usually discovered when a person undergoes an electrocardiogram or echocardiogram for a different reason and the test shows abnormalities suggestive of damage to the heart.

Just because a heart attack didn't cause chest pain or other severe symptoms doesn't mean it shouldn't be taken seriously. Individuals who have had silent heart attacks are at high risk of having additional episodes, one of which could be fatal or cause enough damage to lead to heart failure. If you have had a silent heart attack, you should be every bit as attentive to controlling your risk factors for atherosclerosis as someone who has had the traditional "noisy" kind.

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