Because it doesn’t produce symptoms, a silent heart attack is diagnosed only retrospectively, when evidence of a myocardial infarction (heart attack) is found on an electrocardiogram in a person without a clinical history of having had a heart attack.1

Usually, the diagnosis is made when the patient is seeing a doctor for a completely unrelated reason. When the diagnosis of a prior heart attack is finally made, typically both the patient and the doctor are surprised.

Symptoms

Most people who are having a heart attack know right away that something is very wrong. Typically, they experience severe chest pain or some other form of extremely oppressive chest discomfort. A heart attack is usually more than merely “noticeable”—it is often as subtle as being hit in the face by a two-by-four.

While the pain or discomfort may be “atypical” (for instance, it may affect the neck, shoulders, or back instead of the chest itself), it is usually quite difficult to ignore. Additional symptoms are often present, which may include breaking out into a cold sweat, shortness of breath, or feeling weak, lightheaded, or faint.2