silent heart attack
silent heart attack

Silent Heart Attacks: Are You At Risk?

Posted on January 28, 2020 by Henry Ford Health Staff

Heart disease is the leading cause of death for American men and women, striking an estimated 800,000 people every year. Every 40 seconds, someone in the United States suffers a heart attack, according to the Centers for Disease Control and Prevention (CDC).

When people think of a heart attack, they often think about pounding chest pain and an inability to breathe — the result of insufficient blood flow to the heart muscle that characterizes a heart attack. But up to 20 percent of heart attacks are so subtle that they go unnoticed.

"Most likely all of these people had signs of heart disease, but the symptoms weren't significant enough to prompt them to get checked out by a physician," explains Samer Kazziha, M.D., an interventional cardiologist at Henry Ford Health.

Heart Attack Risk Factors

There are multiple factors that influence your risk of developing heart disease and suffering a heart attack, silent or otherwise. The more risk factors you have, the greater your chances of an event.

Some of these factors are beyond your control. Others are modifiable. Still others may contribute to stress on your heart but may not be directly involved in the development of heart disease. Here's how it breaks down:

Factors You Can't Change:

  • Increasing age: The risk of a heart attack increases with age.
  • Gender: Men are more likely than women to have visible heart attacks, but women are more likely to have silent heart attacks.
  • Genetics: People who have a family history of heart disease are at increased risk of heart attack. African Americans, Mexican Americans, American Indians, native Hawaiians and some Asian Americans are also at increased risk of heart disease and heart attack.

Factors You Can Change:

  • Smoking: Cigarette smoking not only increases your heartbeat (it's a stimulant), but it also dramatically increases your risk of heart attack.
  • High cholesterol: Elevated cholesterol levels can restrict blood flow through the arteries and damage blood vessels. The end result: Your heart beats faster than normal.
  • High blood pressure: High blood pressure overtaxes the heart muscle. Over time, the pressure builds, causing the heart muscle to stiffen, thicken and perform less optimally.
  • Body weight: People who are overweight or obese, especially when their weight tends to sit at the waist, are more likely to develop heart disease. This is true even if they don't have other risk factors.
  • Diabetes: Diabetes dramatically increases the risk of heart disease, heart attack and stroke, even if your blood sugar levels are stable. In fact, roughly 70 percent of people with diabetes over 65 die of heart disease and related complications. Diabetes also increases your risk of silent heart attacks symptoms such as fatigue and shortness of breath.
  • Physical inactivity: Regular, moderate-to-vigorous exercise helps keep other risk factors in check, including cholesterol, blood pressure, diabetes and obesity. If you're not physically active, you're missing out on that protection.

Contributors To The Development Of Heart Disease:

  • Stress: Researchers are increasingly linking chronic stress to heart disease and heart attacks.
  • Alcohol: Heavy drinking can not only kick up your blood pressure, it can overtax your heart, causing it to beat more quickly.
  • Diet and nutrition: Diet plays a key role in many other risk factors, including high blood pressure and high cholesterol, as well as overweight and obesity.

Silent Heart Attacks Explained

The people who are most vulnerable to silent heart attacks fall into one of three categories: women, people with diabetes and people who are elderly.

"The reason these groups are most at risk is because they don't present with the tell-tale symptom of severe, pounding chest pain," Dr. Kazziha says.

Instead, these people tend to suffer from subtle signs that their heart is deprived of blood and oxygen:

  • Mild chest discomfort
  • Jaw pain
  • Indigestion
  • Nausea
  • Toothache
  • Fatigue
  • A tightness or achiness that comes and goes

Heart Attack Prevention Basics

When it comes to preventing a heart attack — silent or otherwise — getting a baseline evaluation is key. If you have multiple risk factors for heart disease, you should see a heart specialist when you're in your 40s.

Even without heart disease risk factors, every adult should get a baseline evaluation when they turn 50. "You may have suffered a silent heart attack, even if you had no signs of an event," Dr. Kazziha says. So it's important to be honest about any symptoms, even if you think they're nothing to worry about.

To really assess your heart health, your doctor may order blood tests, an echocardiogram and various stress tests. If you have diabetes, your doctor may also recommend intermittent testing.

"One of the most common reasons for not getting a cardiac evaluation is fear. People don't want to get checked because they're afraid of what the doctor will find," Dr. Kazziha says. But if you face heart disease head on with lifestyle changes and medication when necessary, you can reduce your risk of stroke, heart attack or a devastating event.

How healthy is your heart? Take the heart risk quiz to find out. To find a doctor or cardiologist at Henry Ford, visit or call 1-800-HENRYFORD (436-7936).

Dr. Samer Kazziha is an interventional cardiologist and the chief of Cardiovascular Services for Henry Ford Macomb Hospital.

Categories : FeelWell

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