Top 20 Heart Questions

Silent Heart Attack

Q: What is a silent heart attack? How do you know if you have had one?

A: Atherosclerosis, the disease process that underlies most heart disease, is caused by a waxy buildup (plaque) in the arteries. The narrowed arteries are referred to as ischemic, and when they become too narrow to permit enough oxygen-rich blood flow to the heart, most people experience chest pain (angina), which is a sign they may be having a heart attack.

It is also possible to experience a restricted blood flow to the heart without having symptoms—which can cause a “silent” heart attack. Only a physician using specialized tests, such as an electrocardiogram or exercise stress test, can diagnose a silent heart attack.

Jennifer H. Mieres, M.D., is director of nuclear cardiology and associate professor of clinical medicine at New York University. She's also a spokesperson for the American Heart Association.