Can you have a heart attack and not know it?

When you think of a heart attack, you probably picture a pretty dramatic event that includes someone experiencing intense chest pain, clutching their arm and dropping to the ground unconscious.

But in real life today, heart attacks aren’t usually that extreme. Some produce no symptoms, or only produce mild symptoms that are so unremarkable that people mistake them for something else — heartburn from a lunchtime burrito, fatigue, or a chest muscle strain.

“The true incidence of silent heart attacks is not known, since by definition they go unnoticed,” says Dr. Michelle O’Donoghue, a senior investigator with the TIMI Study Group, an academic research group studying cardiovascular disease at Harvard-affiliated Brigham and Women’s Hospital. “However, estimates have placed them anywhere from 20% to 60% of all heart attacks.” Both women and men are at risk, she says.

Identifying a silent heart attack

People often don’t learn that they had a heart attack until they have an electrocardiogram (ECG) or a stress test and the doctor notices signs consistent with heart damage. As in traditional symptomatic heart attacks, a silent heart attack involves a blockage of blood flow to the heart. This injures and scars part of the heart muscle, leaving behind telltale signs.

Unfortunately, while a heart attack may go unnoticed, the injury it causes is real and puts you at higher risk for heart failure or a future heart attack.

Take action after a silent heart attack

If you do find out that you’ve had a silent heart attack, you should take steps to prevent or control cardiovascular risk factors, such as high blood pressure, high cholesterol, or diabetes, any of which can make another heart attack more likely.

Doctors don’t completely understand why some people experience no symptoms — or only mild or unusual ones — during a heart attack, Dr. O’Donoghue says. To better identify silent heart attacks, she says, there needs to be more education about less common symptoms, which are often very different from the ones most people picture.

“I think the greatest misconception about a heart attack is that the chest discomfort is ‘painful’ — in fact, most patients describe the chest discomfort as a heaviness or squeezing sensation that can be quite mild in nature,” she says. “Women may also experience more atypical symptoms, like shortness of breath, nausea, sweating, and tingling in the left arm or jaw.”

If you do experience these symptoms, it’s best to get them checked out immediately. Even if they don’t turn out to be heart-related, it truly is better to be safe than sorry.

Be heart smart!Take these steps to head off cardiovascular disease:Talk to your doctor about risk factors. Identify things in your health history that might put you at higher risk for a heart attack, such as high blood pressure, high cholesterol, a family history of heart disease, and diabetes. Don’t forget to mention female-specific risk factors, such as a history of early menopause (before age 40) or a past episode of preeclampsia (a potentially life-threatening pregnancy complication marked by high blood pressure and protein in the urine).Review your risk factors with your doctor. Know that your risk for heart problems may rise after menopause or if your health changes.Get screened. Monitor your blood pressure, and consider getting tested for diabetes if you have risk factors, such as a family history of the disease, overweight or obesity, or gestational diabetes during pregnancy.

Bible verses for today’s meditation and inspiration: Matthew E. McLaren

Rejoice always, pray continually, give thanks in all circumstances; for this is God’s will for you in Christ Jesus. 1 Thessalonians 5:16-18 NIV

The Lord your God is with you, the Mighty Warrior who saves. He will take great delight in you; in his love he will no longer rebuke you, but will rejoice over you with singing. Zephaniah 3:17

Rejoice in the Lord always. I will say it again: Rejoice! Philippians 4:4 NIV

Be joyful in hope, patient in affliction, faithful in prayer. Romans 12:12 NIV

When anxiety was great within me, your consolation brought me joy. Psalm 94:19 NIV

The Lord has done it this very day; let us rejoice today and be glad. Psalm 118:24 NIV

Though the fig tree does not bud and there are no grapes on the vines, though the olive crop fails and the fields produce no food, though there are no sheep in the pen and no cattle in the stalls, yet I will rejoice in the Lord, I will be joyful in God my Savior. Habakkuk 3:17-18 NIV

You make known to me the path of life; you will fill me with joy in your presence, with eternal pleasures at your right hand. Psalm 16:11 NIV

Though you have not seen him, you love him; and even though you do not see him now, you believe in him and are filled with an inexpressible and glorious joy, for you are receiving the end result of your faith, the salvation of your souls. 1 Peter 1:8-9 NIV

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