Silent Heart Attacks: More Men Have Them, But More Women Die from Them

by Amy Hendel, P.A. Health Writer

Did you know that nearly half of the heart attacks experienced will be silent? That means few identifiable symptoms — or no symptoms at all — to clue you in to this serious health event. Patients with diabetes or hypertension have a higher risk of having a silent heart attack or myocardial infarction, but it can happen to anyone. According to a new study, silent heart attacks appear to be more common in men, but the death rate from the phenomenon is higher in women.

Heart attack facts

More than one million individuals in the U.S. have heart attacks every year. A heart attack occurs when blood flow going to the heart is blocked. That results in the heart not getting oxygen. If not treated quickly, the heart muscle will fail to pump blood and heart tissue will begin to die. If you have coronary artery disease your risk of having a heart attack escalates. About half of the individuals who die from a heart attack die in the first hour post event. Almost 14 million Americans have a history of heart attack or angina. The most common time for a heart attack is Monday morning, followed by Saturday morning. On average, women take two to four hours longer than men to respond to symptoms that might indicate a heart attack.

A silent heart attack or silent ischemia is also called the silent killer. The event is more likely to occur in someone who has had a prior heart attack; individuals diagnosed with diabetes; women; women and men over age 65; and in individuals with a higher stroke risk.

Symptoms of a heart attack

Men and women can have different heart attack symptoms. Men will have the more typical signs which can include:

  • Chest pain or discomfort

  • Upper body discomfort

  • Shortness of breath, even at rest

  • Breaking out in a sudden cold sweat

  • Feeling unusually tired

  • Nausea and vomiting

  • Lightheadedness or sudden dizziness

Women may also have chest pain, but they are more likely to experience:

  • Shortness of breath

  • Tiredness for several days

  • Nausea and vomiting

  • Pain in the back, shoulders or jaw

More heart facts

Nearly half of all heart attacks may be silent without the usual chest pain, shortness of breath and cold sweats. Silent heart attacks are found “after the fact,” by clinical examination when a doctor suspects that the event has occurred, and confirms the diagnosis with cardiac testing. Both silent and symptomatic heart attacks overall are more common in men compared to women but premenopausal women as a group have more silent heart attacks.

When comparing the two genders, women are more likely to die from a silent heart attack. Women with silent heart attacks are 58 percent more likely to die compared to women with no history of heart attacks. Mortality rate for men with a silent heart attack hovers around 23 percent. Overall, a silent heart attack is associated with a triple risk of dying from heart disease and a 34 percent increased risk of dying from all causes.

New study suggests silent heart attacks more common than previously thought

In a recent study, Dr. Zhu-Ming Zhang of Wake Forest Baptist Medical Center in Winston-Salem North Carolina and his colleagues studied 9,500 middle-age subjects. Half of the group was followed for a full 13 years. During that period, 317 subjects had silent heart attacks while 386 had symptomatic heart attacks. In this group, 1,833 deaths occurred from all causes, while of those deaths, 189 were directly due to heart issues. Death rates among the women in the group were higher. The researchers postulate that this may be due to underuse of therapeutic guidelines or low referral rates of women to cardiac rehabilitation services after diagnosis of a heart attack.

Prior studies have confirmed higher rates of silent heart attacks in younger women. It may be that they actually experience symptoms but somehow don’t take symptoms like chest or stomach discomfort seriously. In general, many patients downplay symptoms that could be signs of a heart attack. The problem is that there is a period called the golden hour right after a heart attack occurs, during which time identifying and treating a possible heart attack can mean less chance of cardiac tissue death. Popping an aspirin can make a huge difference in the outcome. Just getting a diagnosis can make a huge difference, too. Learn the typical and atypical signs of a heart attack and always, always check out even the slightest suspicions. The life you save may be your own.



Amy Hendel, P.A.
Meet Our Writer
Amy Hendel, P.A.

Known as "The HealthGal", Amy Hendel P.A. is a medical and lifestyle reporter, nutrition and fitness expert, health coach and brand ambassador. Trained as a physician assistant, she maintains a health coach private practice in New York and Los Angeles. Author of The Four Habits of Healthy Families, find her on Twitter @Healthgal1103 and on Facebook @TheHealthGal. Check “Daily Health News” at Her personal mantra? “Fix it first with food, fitness, and lifestyle.”