Silent Heart Attacks


August 10, 2021
Reading Time: 2 minutes

A silent heart attack or silent myocardial infarction (SMI), also called a silent Ischemia, is a heart attack that has either no symptoms, minimal symptoms or unrecognized symptoms. A heart attack is not always as obvious as pain in your chest, shortness of breath and cold sweats. A heart attack can actually happen without a person knowing it. You can understand why it is called a “silent” heart attack.

A silent heart attack happens when the flow of blood is blocked in the coronary arteries by a build up of plaque. Some studies suggest silent heart attacks are more common in women than in men.

SMI symptoms are often mild and brief.

Seek immediate medical attention if you experience one or more of the following:

  • Discomfort in the center of the chest that lasts several minutes, or goes away and comes back. It can feel like an uncomfortable pressure, squeezing, or pain.
  • What feels like muscle strain in your chest or upper back.
    • Discomfort in other upper-body areas, such as one or both arms, the back, the neck, the jaw, or the stomach.
  • Shortness of breath before or during chest discomfort.
  • Breaking out in a cold sweat, or feeling nauseated, or lightheaded.
    • Flu-like symptoms.
  • Feelings of indigestion.

SMI’s are described as “silent” because when they occur, their symptoms lack the intensity of a classic heart attack, such as extreme chest pain and pressure; stabbing pain in the arm, neck, or jaw; sudden shortness of breath; sweating, and dizziness.

“SMI symptoms can feel so mild, and be so brief, they often get confused for regular discomfort or another less serious problem, and thus men ignore them,” says Dr. Jorge Plutzky, director of the vascular disease prevention program at Harvard-affiliated Brigham and Women’s Hospital.

SMI and regular heart attacks share the same risk factors:

  • stress
  • high blood pressure
  • smoking
  • being overweight
  • lack of exercise
  • high cholesterol levels
  • diabetes
  • age
  • family history of heart disease

People who have an SMI and don’t get treatment have a three times greater risk of dying from coronary artery disease.


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