Can I have a heart attack without chest pain, a silent heart attack?

Yes, it is Unfortunate but as a cardiologist, we see many patients presenting with complications of heart attack and on history, they deny any acute severe chest pain

Diabetes, Old age and chronic kidney disease are the most common associated diseases in which this happens

A silent heart attack is diagnosed most commonly in two scenarios. A patient goes for a routine annual health check-up or any pre-procedure check-ups and comes to know that he had echo abnormality. The second scenario is worse where the patient continues to worsen without chest pain but develops other symptoms like swelling all over the body and breathlessness and goes to doctor other than a cardiologist.

The ECG and Echo are the basic investigations sufficient to tell the extent of damage caused by a silent heart attack. To know whether a heart attack is recent one or older than a few weeks, we advice blood markers, most commonly troponin.

Management depends on many factors but mainly clinical condition and extent of damage as shown in the Echo.

We have commonly seen patients in denial mode and there is a reason for that, They just don’t know that it is possible and rather quite common.

I request my dear patients to give the same attention to your silent heart attack like the one with severe chest pain, as the damage is not depending on the severity of chest pain.


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