"Silent" heart attack?

Originally Published: September 19, 2008 - Last Updated / Reviewed On: February 28, 2014
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Dear Alice,

Is it possible to have a heart attack without knowing you're having a heart attack?

Thanks,
Neil O.

Dear Neil O.,

If you have any inkling that you may be having some serious health problems, seek help immediately! As flattering as it can be to hear from you, Go Ask Alice! is no substitute for emergency care! That said, hopefully the information here will answer your question. Although most people who suffer a heart attack realize what is happening, it is possible to not know that you've suffered a heart attack. Symptoms of a heart attack are sometimes similar to other conditions. These include:

  • Chest pain
  • Nausea and/or vomiting
  • Shortness of breath
  • Fainting
  • Dizziness
  • Sweating
  • Anxiety
  • Cough
  • Indigestion

As you can see, most people have had some or all of these symptoms at one time or another (think taking the SATs, going on a first date, etc.). Also, heart attack symptoms may be different for men and women. Although chest pain is a major symptom, some people do not experience chest pain during a heart attack. These so called 'silent' heart attacks are more common in people with diabetes and the elderly, but can occur in others. One study suggested that as many as 1 in 5 people over 65 who had suffered a heart attack had symptoms that they didn't associate with a heart attack. Silent heart attacks are particularly worrisome because seeking prompt treatment after a heart attack is essential for optimal recovery.

There are steps you can take to reduce your chances of having a heart attack. First, if you have risk factors such as obesity, smoking, lack of exercise, high blood pressure or high cholesterol, and/or a family history of heart attack, see a health care provider. A trained professional can help you manage these concerns and learn about healthy behavior changes to reduce your risk. Secondly, learn to recognize the "silent" symptoms (the symptoms listed above, except for chest pain) since they really aren't silent, just unnoticed.

The best thing you can do if you think you may have experienced a heart attack, or are concerned about your heart health, is to make an appointment with a health care provider. If needed, a cardiologist may give you an electrocardiogram to detect if there is any heart damage from a previous heart attack, and will help you determine your risk and what you can do to take care of your health. Columbia students can contact Medical Services (Morningside) or the Student Health Service (CUMC) for an appointment with a health care provider.

Your heart works very hard to keep you going, beating an average of 72 times per minute. That's more than a billion beats in your lifetime! You can do your part to keep it healthy by choosing a healthy lifestyle and seeking medical care if you have symptoms.

Alice