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7 Silent Signs of a Heart Attack

Chest pain or pressure, cold sweat, extreme weakness—you know those heart attack signs. But there are more subtle symptoms that can be easy to miss.

Surprising signs of a heart attack

Every year, an estimated 805,000 people in the United States have a heart attack. Heart attacks can occur if you have heart disease-related clogging of the arteries, which is known as atherosclerosis. Fatty plaques can form in the heart’s arteries and sometimes rupture, triggering blood clots that block blood flow to the heart.

A heart attack is not the same as a cardiac arrest. With a heart attack, the heart continues to beat, but the reduction of blood flow to the heart muscle may trigger pain or other symptoms—some obvious and others more subtle. (These are the symptoms of cardiac arrest, which happen when your heart stops beating.)

It’s important to identify the signs of a heart attack as soon as possible. The quicker you get treatment, the more likely you are to survive without permanent damage to the heart muscle. You probably know chest pain is a heart attack symptom. People in movies and on TV who are having a heart attack often clutch their chest in pain. (That said, chest pain can occur because of these eight other reasons, too.)

However, in real life, the signs are often less obvious. Even this man mistook his heart attack for a cold. In particular, women’s heart attack symptoms can be different from those in men.

To help you recognize the silent signs of a heart attack, we spoke with cardiologists and other experts who share the subtle symptoms you shouldn’t ignore.

Man yawning while sitting at a deskistock/Yuri_Arcurs


Cardiologist Stacey E. Rosen, MD, says this is one of the most common signs of a heart attack she sees, especially in female heart attack patients. “In my 25 years of practice, people on the verge of a heart attack report feeling tired and not able to do their usual activities,” says Dr. Rosen, the vice president for women’s health at the Katz Institute for Women’s Health at North Shore-LIJ Health System in New Hyde Park, New York.

During a heart attack, blood flow to the heart is reduced, putting extra stress on the muscle, which could make you feel exhausted. If you’re feeling fatigued, it’s smart to talk to your doctor about why. He or she will decide if an electrocardiogram (EKG), which checks heart activity, or another heart test, is necessary. (This silent heart attack survivor shares how skipping a nap saved his life.)

woman upper back neck painTHANYAKORN / Shutterstock

Soreness in the back, arms, or chest

Noticeable pain or soreness in the back, chest, or either arm is often a sign of a silent heart attack. Because the pain is often not accompanied by the typical chest heaviness associated with heart attack, people tend to ignore it, says Dr. Rosen.

“I’ve had patients say they only felt the pain when they were working out, so they assumed it was just from exercise, but that’s not right,” she says. “If the symptom is something new, that’s worrisome and you should see a doctor.”

doctor listening to patient's heartER Productions Limited/Getty Images

Shortness of breath

If a flight of stairs is usually no problem but suddenly you find yourself gasping for air at the top, it could signal a heart attack. “Women especially tell me they noticed feeling fatigued or breathless while walking up steps or carrying groceries when they normally wouldn’t,” says Dr. Rosen.

If you feel short of breath right after waking up, that’s also a sign that something could be wrong, says Annapoorna Kini, MD, a cardiologist and professor of medicine at the Icahn School of Medicine at Mount Sinai in New York City. The heart plays a key role in transporting oxygen to the rest of your body and removing carbon dioxide from tissues, so blocked blood flow to the heart could affect your breathing.

Woman holding a glass of water with one hand and her temple with the other handistock/OJO_Images

Heartburn or belching

If you have an occasional heartburn flare-up after a heavy pizza lunch, it’s probably nothing to worry about. But if it’s out of the ordinary or heartburn has never bothered you before, call your doctor because it could signal a heart attack. Angina, a heartburn-like chest pain, is caused by lack of blood flow to the heart, which is what happens during a heart attack, says Ryan Madanick, MD, assistant professor of medicine at UNC School of Medicine in Chapel Hill, North Carolina.

woman with stomach painAaron Amat/Shutterstock

Stomach upset

Heart attack symptoms can sometimes mimic stomach problems like nausea, vomiting, or overall gastrointestinal upset—especially in women, says Dr. Rosen. “If you don’t feel well, always call your doctor. It could be that taco you had at 10 p.m., but it could also be a heart attack,” she says.

woman holding her throatistock/Remains

Throat, neck, or jaw discomfort

Unexplained discomfort in the neck or jaw or tightness in the throat you’ve never felt before can indicate a heart attack, says Dr. Kini—those are signs you should immediately contact a doctor. It’s especially important for people with diabetes to pay attention to subtle changes like this because they have trouble feeling sensations and are less likely to feel more typical symptoms like chest pain, says Dr. Rosen.


An overall feeling that something’s wrong

“Heart attack patients have told me they have a feeling of doom—like something’s just not right,” says Dr. Rosen. “Listen to that little voice in your head. If something feels off, it’s always better to be overly cautious and call a doctor.” In addition, Dr. Rosen says some of her patients have reported feeling “less mentally sharp” right before a heart attack. (Also, make sure to try these everyday ways to reduce your heart attack risk.)

  • Centers for Disease Control and Prevention: "Heart Disease Facts"
  • Stacey E. Rosen, MD, cardiologist and vice president for women's health at the Katz Institute for Women's Health at North Shore-LIJ Health System in New Hyde Park, New York
  • Annapoorna Kini, MD, cardiologist and professor of medicine at the Icahn School of Medicine at Mount Sinai in New York City
  • Ryan Madanick, MD, assistant professor of medicine at UNC School of Medicine in Chapel Hill, North Carolina
Medically reviewed by Oscar H. Cingolani, MD, on August 01, 2019

Alyssa Jung
Alyssa Jung is a writer and editor with extensive experience creating health and wellness content that resonates with readers. She freelanced for local publications in Upstate New York and spent three years as a newspaper reporter before moving to New York City to pursue a career in magazines. She is currently Senior Associate Editor at Prevention magazine and a contributor to Previously she worked at Reader's Digest as an editor, writer, and health fact checker.

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