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Silent heart attacks, known as a silent myocardial infarction (SMI), account for 45 percent of heart attacks. And they are more likely to strike men than women.
These heart attacks are mistaken for less serious problems, increasing your risk of dying.
Don’t be one of those people who waits too long before getting help. Knowing the signs and taking them seriously can save your life.
These types of heart attacks are described as "silent" because when they happen, their symptoms may not seem like a classic heart attack. There may be no extreme chest pain and pressure. No stabbing jaw, neck or arm pain. No overwhelming sudden shortness of breath, dizziness or sweating.
Symptoms can pass quickly and feel mild, but silent heart attacks damage your heart and can lead to life-threatening problems. Silent signs may include:
The symptoms can easily be confused with indigestion or general aches or pains, leading men to ignore them. But a silent myocardial infarction is just as dangerous as other heart attacks.
Let your doctor know if you think you may be having symptoms. You can decide together if you need to have testing or see a heart specialist.
Take it seriously. Heart disease is the leading cause of death in the U.S. The best ways to protect yourself are awareness and prevention.
Do what you can to lower your risk. The risk factors for silent heart attacks are the same as any other heart attack. They include smoking, being overweight and not exercising. Health conditions like high blood pressure and high cholesterol levels raise your risk, as does diabetes. Getting those health problems under control is important for your overall health and safety.
To lower your risk:
Don’t skip preventive health care. Men tend to go to the doctor less often than women for annual checkups, says Johns Hopkins Medicine. That means they may not get important routine tests for cholesterol, blood pressure and blood sugar. Those tests help gauge heart health.
Skipping preventive exams and screenings also means men are less likely to find out if they have damage called myocardial scars from a silent heart attack. One study found that 80 percent of people who had myocardial scarring were not aware of it. And the study found that men were five times more likely to have myocardial scarring than women.
Don’t assume you’re too young to worry about it. Some men with a family history of early heart attacks can be at risk as early as their 30s or 40s. Learn your family history and talk to your doctor about it.
Ask for help. If you’re feeling depressed, don’t ignore it. Depression is linked to heart disease. Many men try to mask depression by self-medicating or with other unhealthy behaviors rather than getting help. If you’ve consistently been feeling sad or hopeless for longer than a few weeks, talk to your doctor.
Manage stress. Stress can raise your blood pressure. Extreme stress can be a "trigger" for a heart attack. And some ways people cope with stress, like overeating, excessive drinking and smoking, are also bad for your heart. Better ways to address stress: working out or other active hobbies, listening to music, getting outdoors, and meditation.
Control diabetes. Having diabetes doubles your risk of heart disease. That’s because high blood sugar from diabetes can harm your blood vessels and the nerves that control your heart. It is vital to get tested for diabetes, and if you have it, to keep it under control.
Make time for sleep. Not getting enough sleep can also raise your risk for high blood pressure, obesity and diabetes. And all of those can increase your risk for a heart attack. Most adults need at least seven hours of sleep per night. If you regularly have sleep problems, talk to your doctor.
Take steps to protect your heart and health now. And if you ever think you might be having a heart attack, don’t hesitate. Call 911 right away.
Originally published 5/3/2021; Revised 2023
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