Can a heart attack happen without chest pain?

Yes, it is possible for a heart attack to occur without experiencing clear chest pain. While chest discomfort is one of the most common symptoms, the symptoms of a heart attack can vary significantly from person to person and can range from mild to severe [1]. This means some individuals may experience a silent heart attack or have atypical symptoms that do not include sharp chest pain.

Atypical Heart Attack Symptoms

In addition to chest discomfort, which may be described as pressure, squeezing, fullness, or pain, and which lasts for more than a few minutes and may come and go, there are other symptoms to watch for, especially if there is no chest pain. These symptoms may include:

• Shortness of breath: This may sometimes be the only symptom and may occur before or during chest discomfort, whether you are at rest or performing light physical activity [1].
• Upper body discomfort: You may feel pain or discomfort in one or both arms, the back, shoulders, neck, jaw, or the upper part of the stomach [1].
• Other symptoms: May include nausea, vomiting, dizziness, palpitations (a racing or pounding heart), and feelings of lightheadedness or fainting; you may also develop a cold sweat [1].

It is important to note that women may sometimes experience symptoms different from men; for example, they are more likely to experience fatigue without a clear cause [1].

What to do if you suspect a heart attack?

If you suspect that you or someone else is experiencing heart attack symptoms, even if you are not sure or there is no chest pain, you must seek emergency medical help immediately. Emergency medical services can begin treatment as soon as they arrive, and calling them ensures you receive care faster [1]. Every minute counts in limiting damage to the heart muscle.

Preventing a Heart Attack

Prevention is vital to reducing the risk of a heart attack, even if you do not experience typical symptoms. There are many risk factors that can be controlled and modified to lower this risk, including:

• Quitting smoking: Smoking is a major risk factor that can be stopped or avoided entirely [1].
• Managing cholesterol and high blood pressure: Both can be controlled through diet, exercise, and medication [1].
• Controlling diabetes: Managing blood glucose levels is crucial [1].
• Physical activity and a healthy weight: Maintaining physical activity and a healthy weight reduces risks [1].
• Stress management: Learning healthy ways to cope with stress [1].

Additionally, doctors may prescribe a daily aspirin to reduce the risk of heart attack and clot-related strokes in patients who have cardiovascular disease or who have already had a heart attack or stroke [3]. However, daily aspirin use is not suitable for everyone and must be done under the supervision of a specialist doctor after evaluating medical history and potential risks and benefits [3]. Aspirin can cause serious side effects, such as stomach bleeding or brain bleeding [3].

Follow-up after a heart attack

After having a heart attack, the risk of experiencing another one increases [1]. Therefore, it is essential to speak with a healthcare provider about the necessary steps to reduce this risk, which may include medications and lifestyle changes to improve heart health [1]. You can read more about this topic in Heart Attack: Warning Signs, First Aid, and Prevention (Arabic).

Medical references

• Heart Attack
• Aspirin for Reducing Your Risk of Heart Attack and Stroke: Know the Facts