For most of us, a heart attack would be a sudden, sharp pain in the left side of the chest. But what if we tell you that a person can get a heart attack and yet show minimal to no symptoms? A silent heart attack, medically called a silent myocardial infarction, usually occurs without any symptoms, therefore often goes unrecognized. Moreover, statistics reveal a silent heart attack accounts for about 45% of all cases of heart attacks. 

What is the cause of a silent heart attack?

A silent heart attack can occur due to an obstruction in the coronary artery, the blood vessels that bring oxygen-rich blood to the heart. The obstruction in the coronary artery can be due to a dislodged piece of fatty plaque from the inner lining of the arteries. This blockage can cause a blood clot to form in the heart, resulting in a heart attack.

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What are the symptoms of a silent heart attack?

While some people suffering from a silent heart attack may not experience any symptoms, others may feel a crushing pain or pressure in the chest that radiates to the jaw or arm. Some of the common signs of a silent heart attack include:

• Persistent fatigue 
• Shortness of breath
• Heartburn
• Gastric reflux (belching)
• Indigestion 
• Burning sensation in the middle of the chest
  
• Feeling uneasy and sluggish 
• Breaking out in a cold sweat
• A feeling of fainting or dizziness 
• Weakness

• Discomfort in the throat, neck or jaw. 

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The presence of all these symptoms does not conclude a silent heart attack. Proper tests need to be performed by a doctor to reach a diagnosis. 

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Which tests are required to diagnose a silent heart attack?

Since there are no tell-tale signs of a silent heart attack, it can be detected with the help of:

• Electrocardiogram (EKG) and Echocardiogram: These tests help in determining any abnormality in the heart muscle, valves, or rhythm.
  
• Troponin test: Troponin test is a blood test used to determine the levels of troponin T, a protein released in the body by the injured heart cells.
• MRI: This imaging test helps in determining the blood flow to the heart. 

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Who is more likely to suffer from a silent heart attack?

Risk factors for a silent heart attack include: 

• Family history of heart disease
• Old age
• Smoking
  
• High cholesterol levels 
• High blood pressure (hypertension)
• Diabetes
• Physical inactivity 
• Obesity (body mass index of more than 30)
• Consuming fatty and fried processed foods

Can a silent heart attack be prevented?

While there is no definite way of preventing a silent heart attack, some necessary lifestyle changes that may reduce the risk are: 

• Quitting smoking and limiting the consumption of alcohol to not more than two drinks a day.
• Avoiding high-fat and processed foods as they increase cholesterol levels.
• Adding antioxidant-rich and fibrous foods such as carrots, garlic, lemon, tomatoes, walnuts, apples, turmeric, fruits, vegetables, whole grains, legumes and healthy unsaturated fats found in fish, nuts and seeds to the diet. 
• Avoiding the consumption of high amounts of salt or canned food as they can increase blood pressure.

• Exercising regularly for at least 30 minutes a day to maintain healthy body weight.
• Sleeping for at least 7 to 8 hours a day.
• Getting blood sugar and blood pressure levels checked regularly. Report any significant change to the doctor.

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Since silent heart attacks often exhibit no symptoms, they are considered more dangerous than the ones that present with early warning signs. Limiting the intake of unsaturated fats, quitting smoking, exercising regularly, and getting good sleep can help keep the heart healthy. People must keep their blood sugar, blood pressure, and cholesterol levels in the optimal range with the help of a healthy diet, physical activity and medications if needed. One must consult a doctor or cardiologist if one experiences sudden and unexplained fatigue, dizziness, or nausea that gets worse on exercising. 

For more information

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Medically reviewed by Dr Sonia Bhatt.