Not every case of heart disease is as dramatic as what you see on Grey’s Anatomy. In fact, according to a 2017 report from Harvard Health Publishing, some 45 percent of heart attacks are categorized as silent myocardial infarctions (SMIs), meaning that “when they occur, their symptoms lack the intensity of a classic heart attack.” And, according to the Centers for Disease Control and Prevention (CDC), approximately half of all men who die of coronary heart disease have no previous symptoms whatsoever.
But if not every heart disease diagnosis is glaringly obvious, then how
are doctors—let alone you—supposed to know if your ticker’s a time bomb?
Getting a routine checkup is a good place to start, but it also pays to
learn these silent signs of a heart attack so you know if and when to
seek emergency treatment.
1- Hot Flashes
Women going through menopause aren’t the only people who experience hot
flashes. When Canadian researchers surveyed 1,015 heart attack patients
in 2013, they found that approximately 45 percent of men experienced
this symptom—both with and without accompanying chest pain.
2- Cold Sweats
Breaking out in a cold sweat could mean more than just a case of nerves.
In the same Canadian study, cold sweats were one of the most common
symptoms associated with a silent heart attack. Approximately 47 percent
of men experienced this symptom, compared to just 40 percent of women.
3- Shoulder Pain
While some men having a heart attack—86 percent, to be exact—experience
chest pain as a symptom, others feel the agonizing discomfort of
myocardial infarction in their shoulder. In the same 2013 Canadian
study, 41 percent of male heart attack patients said that they
experienced pain in either their left arm or shoulder.
4- Arm Pain
“A typical heart attacks can have a wide range of presentations,”
explains Dr. David Gatz, an emergency physician at Mercy Medical Center
in Baltimore, Maryland. “Pain or discomfort will frequently still be a
part of the presentation, but may not involve the chest. Examples might
include arm or neck pain.”
Indeed, in the Canadian study, 19 percent of men noted that they’d
experienced neck pain, and 26 percent noted having pain in both arms at
some point.
5- Toothaches
Toothaches don’t always mean it’s time to schedule a trip to the
dentist. Rather, for a surprising number of male heart attack victims—13
percent in the Canadian study, to be exact—tooth pain was one of the
silent symptoms of their heart problem.
6- Headaches
Since headaches are such a common malady, it’s easy to brush them off as
being stress-related or tied to a lack of sleep. However, in some
instances, that headache may be an indication of a serious heart issue.
In the Canadianstudy, 16 percent of male patients reported experiencing a
headache while they were having a heart attack.
7- Weakness
A general feeling of lethargy and frailty could mean that you have the
flu—or it could indicate that you’re having a heart attack. In the ER,
“some [heart attack] patients report more vague symptoms like
generalized weakness, while still others report an ominous sensation
that they’re going to die,” says Gatz.
8- Fatigue
According to the American Heart Association, unexplainable fatigue is
one of the most common silent signs of heart disease. That’s because
when the heart is unable to pump an adequate amount of blood throughout
the body, the circulatory system responds by diverting blood away from
less vital organs, like the muscles in your limbs. This, in turn, causes
the tiredness that patients with heart disease often experience.
9- Throat Pain
“Typical symptoms [of a silent myocardial infarction] like mild pain in
the throat or chest can be confused with gastric reflux, indigestion,
and heartburn,” explain the editors at Harvard Health. Since so many
patients mistake this warning sign for something less severe, they often
put off seeing a doctor until their condition has worsened past the
point of treatment—making it all the more important for individuals to
pay attention to this symptom when it occurs.
10- Pressure in the Center of the Chest
Though most people associate heart disease with pain on the left side of
the chest—where the heart is located—it is actually more common for a
person experiencing a heart attack to feel pressure or pain in the
center.
“Heart attacks most often cause discomfort in the center of the chest,
along with a sensation of unremitting squeezing, fullness, or
tightness,” cardiologist Dr. Curtis Rimmerman, MD, explained to the
Cleveland Clinic.
11- Nausea
Feeling sick to your stomach? It could be because that sushi you ate at
lunch was past its prime—or it could be a silent sign your heart isn’t
working like it’s supposed to. This happens because, during a heart
attack, the heart diverts blood away from the digestive system, thereby
causing unpleasant gastrointestinal issues.
12- Lightheartedness
If you’re experiencing serious lightheadedness, it could be your heart
crying out for help. This occurs because, when your heart isn’t working
effectively, your major organs—like your brain—are getting less blood
and therefore can’t function properly. Usually, you can differentiate
dizziness caused by heart disease from less serious lightheadedness
thanks to the accompanying symptoms.
13- Shortness of Breath
Unless you’re running a 5K or taking an intense spinning class, you
shouldn’t be gasping for air like your life depends on it. “New
shortness of breath with exertion can be concerning,” notes Dr. Gatz. If
you find yourself short of breath while sleeping or watching TV, this
could be because blood is backing up in your pulmonary veins and leaking
into your lungs where it shouldn’t be.
14- Back Pain
Pain anywhere in your upper body could be a symptom of heart disease—not
just your chest. According to the Cleveland Clinic, when the heart is
having difficulty functioning, it activates nerves that can trigger pain
elsewhere in the body. So, if you’re dealing with discomfort in your
back and you can’t explain why, it might be time to get your heart
checked out—just to be safe.
15- Difficulty Sleeping
Sleep problems aren’t just a risk factor for heart disease—they’re also a
symptom. The shortness of breath and heart palpitations often
associated with heart disease are a frequent precursor to sleep
disturbances like sleep apnea, orthopnea, and insomnia in the months
leading up to a heart disease diagnosis. The good news? Those sleep
disturbances usually subside once their root causes are treated.
16- Confusion
Feeling confused isn’t necessarily a sign that something’s amiss with
your brain. According to the American Heart Association, heart failure
directly impacts how much sodium is in your blood, and this, in turn,
can lead to confusion and impaired thinking.
17- Numbness
You can once again thank impaired blood flow for this subtle heart
attack symptom. Because a heart attack causes the blood vessels
throughout the body to narrow, it limits the amount of blood your
extremities receive and therefore causes them to go numb.
