What Is A Silent Heart Attack?

You have witnessed the Hollywood heart attack in all its chest-clutching, breathless melodrama enough times to act it out yourself, but what is a silent heart attack? Silent heart attacks sneak up like ninjas, attacking and fleeing without a single symptom. Most of the time, you never even know what hit you, and although it sounds crazy, this is one case where a pain-free injury does you no favors.

Before you can appreciate the full horror of a silent heart attack, you have to understand how a heart attack—or myocardial infarction—damages your heart, silent or not. Special blood vessels called coronary arteries feed oxygen-carrying blood to the heart. When all those super-sized French fries catch up to you and clog your coronary arteries shut, it cuts the heart off from its oxygen source, inflicting serious tissue damage.

Unlike those traditional heart attacks, which can feel like someone swung a kettle bell into your chest, silent heart attacks have no symptoms at all. You feel nothing, even as your heart tissue struggles to survive. To make this even creepier, one fifth of all heart attacks are silent. While it might sound preferable to avoid all the horror and pain of a traditional heart attack, consider this: You really need to know if you had a heart attack. Pain actually does you that favor; no pain leaves you blissfully unaware of the damage.

Worse, because heart tissue cannot regenerate after an attack, your heart gets stuck with scar tissue, which can lead to arrhythmias or even clots. Just one more heart attack, silent or not, could prove fatal, because the heart has no more capacity to withstand having its oxygen cut off.

Technically, though, a silent heart attack is the most extreme form of a condition called "silent ischemia"—chronic oxygen and blood deprivation to part of the heart. The best way to detect this condition is to see your doctor for an exercise stress test or a Holter monitor to record your heart rate and rhythm over a 24-hour period. While you are at it, get your cholesterol and blood pressure screened. High cholesterol and blood pressure are both major risk factors. 

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Heart Attack

Silent Heart Attack

Silent Ischemia