What’s a ‘Silent’ Heart Attack?

What's a 'Silent’ Heart Attack? on onebeatcpr.com

It’s a surprisingly common occurrence, which is why it pays to know the warning signs

What do you think about when you image somebody having a heart attack? Most likely you picture someone (probably a man) clutching his chest or breathlessly saying his left arm hurts. And while not entirely wrong, these are not the only signs of someone having a heart attack. In many cases – almost half, in fact – people experience what’s known as a silent heart attack.

What exactly is a “silent” heart attack?

A silent heart attack, also known as a silent myocardial infarction (SMI), gets its name due to the fact that the symptoms aren’t over; there isn’t intense chest or neck pain or sudden dizziness. In many cases, people don’t even know they’re having a heart attack, says Dr. Jorge Plutzky, director of the vascular disease prevention program at Brigham and Women’s Hospital in Boston.

“SMI symptoms can feel so mild, and be so brief, they often get confused for regular discomfort or another less serious problem,” Plutzky explains. “People can even feel completely normal during an SMI and afterward, too, which further adds to the chance of missing the warning signs.”

The warning signs of a silent heart attack

Many signs of a silent heart attack are subtle, so it’s important to know what to look out for:


When someone is having a heart attack, less blood flows to the heart, which often makes the person feel extremely tired. This is one of the most common signs of any heart attack, especially for women.

Shortness of breath

The heart is instrumental in getting oxygen to all parts of the body, as well as eliminating carbon dioxide from the tissue. When blood flow to the heart is blocked, this could have an impact on breathing. Feeling short of breath upon waking is a particularly bad sign.

Soreness in certain areas

Though the sharp pain common with a typical heart attack doesn’t happen, there can be some minor pain or soreness. This is because when heart muscle cells lose oxygen, they transmit pain signals. Because of the proximity to the heart, people may feel discomfort coming from their chest, back, arms, neck, or jaw.

Upset stomach

Everyone has an upset stomach now and again, which is why it is often overlooked as the sign of a heart attack. But in many cases, nausea or vomiting could be heart attack symptoms.


Like an upset stomach, heartburn is pretty common with a lot of people. But if you rarely get indigestion or it comes on unexpectedly, this could be a red flag.

Just not feeling right

This one may be a little vague, but nobody knows your body like you do. If you feel off, it’s always better to be safe than sorry, says Dr. Stacey R. Rosen, a cardiologist at North Shore-LIJ Health System.

“Heart attack patients have told me they have a feeling of doom—like something’s just not right,” Dr. Rosen said. “Listen to that little voice in your head. If something feels off, it’s always better to be overly cautious and call a doctor.”

Whether it’s for yourself or someone you live or work with, knowing the signs of a silent heart attack can help ensure that treatment is given as soon as possible. At One Beat CPR, we are dedicated to educating everyone about heart issues and providing expert CPR and first aid training. To see what we offer, you can check out our class schedule.