Silent Heart Attacks: Just As Deadly

Almost half the heart attacks people experience are silent – meaning, the person has the heart attack but does not seek medical attention. Most of them are without symptoms.  But those heart attacks are just as deadly as the ones that drive people to get medical attention.

This the result of a community based study that also showed that both silent heart attacks as well as clinically manifested heart attacks caused damage. The heart attacks that were noted clinically were slightly more deadly than the silent heart attacks. There was no difference between race and sex in the incidence or prognosis of silent heart attacks.

Classic heart attacks cause symptoms of chest or arm pain, sometimes described as a “crushing” chest pain. Silent heart attacks can have symptoms of heartburn, feeling tired, shortness of breath.

Three Silent Symptoms of a Heart Attack:

  1. Increased indigestion. It may be a heart attack and not indigestion at all. This was how my dad’s heart disease was uncovered after he complained that he kept having to buy more antacids. It was not indigestion, it was heart disease.  He thankfully received three stents in his heart and over ten years later is going strong.
  2. Fatigue, especially unexpected fatigue.  It may be that the heart is not functioning well and you attribute the increase in fatigue to working hard, or something else.  After receiving a cardiac stent my father-in-law noted he felt so much better than he had before.
  3. Shortness of breath. People who have asthma attribute shortness of breath to allergies, but it may be secondary to a silent heart attack

If you have those symptoms you need to see a cardiologist and have your heart checked out.  The silent heart attack may not show up on a standard EKG, and the cardiologist may need to run more tests.

In the long run those who have silent heart attacks are at three times the risk to die from heart disease and have a higher risk of dying from other causes.  Treatment includes lowering cholesterol, stopping smoking, weight loss, and some may need to be on aspirin.

Heart disease remains the number one killer in the United States.  Risk factors are highest for smokers, a family history of heart disease, and diabetes.

Flour and Sugar - two deadly ingredients that lead to heart disease

Flour and Sugar – two deadly ingredients that lead to heart disease

Dietary prevention of heart disease includes reduction of processed carbohydrates. While the emphasis for years was to reduce saturated fat, it turns out that these items are worse:

“Unfortunately, most carbohydrates in Western diets are highly processed, including bread, rolls, pizza, white rice, and most ready-to-eat cold cereals and sugar. Prior studies show that these types of carbohydrates are particularly harmful for overweight and obese individuals, suggesting that adverse effects of carbohydrates are aggravated by underlying insulin resistance” (2)

Common ingredients that are responsible for heart disease

Common ingredients that are responsible for heart disease


Weight loss for those who are obese is best accomplished through weight loss surgery after being cleared by a cardiologist.


  1. Circulation. 2016 May 16.  Race and Sex Differences in the Incidence and Prognostic Significance of Silent Myocardial Infarction in the Atherosclerosis Risk in Communities (ARIC) Study. Zhang ZM1, Rautaharju PM2, Prineas RJ2, Rodriguez CJ2, Loehr L3, Rosamond WD3, Kitzman D2, Couper D3, Soliman EZ2.
  2.  Am J Clin Nutr. 2010 Jun; 91(6): 1541–1542.Published online 2010 Apr 21. doi: 10.3945/ajcn.2010.29622
    PMCID: PMC2869506 Are refined carbohydrates worse than saturated fat?
    Frank B Hu
  3. Jakobsen MU, Dethlefsen C, Joensen AM, et al. Intake of carbohydrates compared with intake of saturated fatty acids and risk of myocardial infarction: importance of the glycemic index. Am J Clin Nutr 2010;91:1764–8
  4. Liu S, Willett WC, Stampfer MJ, et al. A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. Am J Clin Nutr 2000;71:1455–617

Dr. Terry Simpson About Dr. Terry Simpson
Dr. Terry Simpson received his undergraduate and graduate degrees from the University of Chicago where he spent several years in the Kovler Viral Oncology laboratories doing genetic engineering. He found he liked people more than petri dishes, and went to medical school. Dr. Simpson, a weight loss surgeon is an advocate of culinary medicine. The first surgeon to become certified in Culinary Medicine, he believes teaching people to improve their health through their food and in their kitchen. On the other side of the world, he has been a leading advocate of changing health care to make it more "relationship based," and his efforts awarded his team the Malcolm Baldrige award for healthcare in 2011 for the NUKA system of care in Alaska and in 2013 Dr Simpson won the National Indian Health Board Area Impact Award. A frequent contributor to media outlets discussing health related topics and advances in medicine, he is also a proud dad, husband, author, cook, and surgeon “in that order.” For media inquiries, please visit

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