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4 silent signs of a heart attack

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Chest discomfortShortness of breathUpper body painFatigueOther symptoms TreatmentsSummary
Some heart attack symptoms, like fatigue and chest discomfort, may be overlooked or mistaken for something else. Identifying these silent signs can help you get treatment.
Medically reviewed by Helen Chen MCMSc, PA-C
Written by Suan Pineda
Updated on

Heart attacks happen when part of your heart suddenly stops getting blood, mainly due to a blockage in the arteries.

Heart attacks, also known as myocardial infarctions, are different from cardiac arrest, where the heart suddenly stops beating.

While some symptoms are clear signs of a heart attack, there are some that you might not realize are signaling a heart attack. These might be known as silent signs. There are four main ones to look out for.

Sex and gender exist on spectrums. This article uses the terms “women,” “men,” or both when discussing people assigned female or male at birth to reflect language that appears in source materials. 

While gender is solely about how you identify yourself, independent of your physical body, you may need to consider how your personal circumstances will affect diagnosis, symptoms, and treatment. Learn more about the difference between sex and gender here.

1. Chest discomfort

An older adult standing on a balcony looking into the distance, thinking about the silent signs of a heart attack.
Florence Goupil/Getty Images

Heart attacks are very common in the United States, where more than 800,000 people have a heart attack every year. Of these, 1 in 5 are silent heart attacks. This means that the person had a heart attack without knowing it.

People having a silent heart attack can feel discomfort in their chest that can range from a feeling of pressure, to a feeling of fullness, to chest pain.

Chest pain occurs because, during a heart attack, blood vessels in your heart constrict and your heart starts working harder to pump blood. 

This feeling can last a few minutes and come and go throughout the day. 

2. Shortness of breath

Shortness of breath is one of the most common symptoms of a heart attack. This happens because, since your heart is not working as it should, it can’t receive oxygen-rich blood and can’t pump enough blood to organs like your lungs. 

Shortness of breath can come with dizziness, lightheadedness, and a cold sweat

3. Upper body pain

When you’re having a silent heart attack, you may experience pain in your arms and shoulders and your upper body in general. 

People can feel pain in the jaw, stomach, back, neck, and even their teeth. This pain can vary in intensity and can come and go throughout the day.

Pain in the upper body during a heart attack is more common among women and might be overlooked if it isn’t a pain in the chest. 

4. Fatigue

Fatigue and tiredness are heart attack symptoms that are more common among women, as well. 

People having a heart attack are fatigued and exhausted because the heart, which isn’t receiving enough oxygen-rich blood, is working extra hard to pump blood to the rest of the body.

Other symptoms 

Other symptoms of a silent heart attack include:

  • nausea
  • indigestion
  • cold sweats
  • lightheadedness
  • feeling of pain, like you have a strained muscle
  • pain in other parts of your body
  • flu-like symptoms

If you experience any of the symptoms mentioned above and in the previous section, call 911 or go to your nearest emergency healthcare service. Silent heart attacks are an emergency — the sooner it’s treated, the higher the chance to avoid damage to your heart. 


Silent heart attacks increase the risk of heart failure by 35%, according to a 2018 study.

So the sooner a silent heart attack is caught by watching out for warning signs, like chest pain, upper body pain, and extreme fatigue, the better the outcome for long-term health. 

Treatment for a silent heart attack includes:

Lifestyle measures are key in preventing a heart attack. Consider:

  • eating a balanced diet, low in sugar and greasy foods
  • practicing regular physical activity
  • reducing stress
  • avoiding or limiting alcohol, if applicable
  • quitting smoking, if you smoke

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A heart attack occurs when part of your heart doesn’t receive oxygen-rich blood. Although your heart doesn’t stop beating, it’s not working correctly. This can lead to symptoms such as fatigue, chest discomfort, pain in the upper body, and shortness of breath.

Symptoms can be overlooked or mistaken for something else. In fact, many heart attacks are silent heart attacks, which means that people don’t know they’re having one. 

It’s important to watch for these silent signs of a heart attack, which is an emergency. The sooner it’s treated, the less damage to the heart it’s caused.

Treatment for a heart attack includes medical procedures and medications. If you experience any of the symptoms mentioned in this article, call or go to the nearest emergency healthcare service. 

Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.

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