When it’s “Heart” to Tell: Silent Signs of Heart Disease

Heart attacks are often imagined as dramatic events: crushing chest pain and a person collapsing. But research shows that silent myocardial infarctions (SMIs) are widespread, particularly among older adults and those with diabetes or hypertension. These attacks occur when blood flow to the heart is blocked. The symptoms are muted and can easily be mistaken for something else. They are problematic precisely because they don’t demand immediate attention. The result? Permanent scarring of the heart muscle, increased risk of heart failure and a higher chance of sudden cardiac death.

Know the Subtle Symptoms

Research studies highlight several subtle but telling symptoms:

• Unexplained fatigue: A persistent sense of exhaustion, even after rest, can signal impaired cardiac output.

• Indigestion or nausea: Often dismissed as gastrointestinal issues, these can reflect a medical condition where blood flow and oxygen supply are restricted in the lower heart wall.

• Jaw, neck or back discomfort: Pain in these areas is a classic “silent” presentation.

• Shortness of breath: Difficulty with routine exertion may indicate reduced oxygen delivery.

• Sweats or dizziness: Autonomic nervous system responses to cardiac stress often masquerade as anxiety or dehydration.

Each of these signs is easy to brush off as something else, but don’t let it happen to you!

When to Call for Help

“Heart disease often develops quietly, without obvious symptoms, which is why awareness of the silent signs is critical,” said Dr. Patrick Kohtz, an Atrium Health Navicent cardiothoracic surgeon. “Shortness of breath, unexplained fatigue, or subtle changes in your daily stamina can all be early indicators. Don’t ignore these signals—schedule regular check-ups and discuss any concerns with your physician. Early detection gives us the best chance to intervene and help you live a healthier, fuller life.”

Here are some warning signs to look out for:

• Pain that doesn’t improve with rest: Musculoskeletal pain often eases when you stop moving or sometimes when you reposition or stretch; cardiac pain may persist.

• Discomfort that worsens with exertion: If climbing stairs or walking makes symptoms worse, that’s a red flag.

• Associated symptoms: Shortness of breath, nausea, sweating or dizziness alongside any of the discomfort listed above should never be ignored.

• Risk factors: If you have diabetes, high blood pressure, high cholesterol or a family history, even mild symptoms deserve urgent evaluation.

These at‑home measures are not diagnostic tools, but they are important clues. The only way to know for sure is through medical evaluation: ECG, blood tests or imaging. If symptoms persist or worsen, don’t wait for them to pass! Seek emergency care immediately. You may feel like it’s silly or like you are overacting, but your friends and family would likely tell you that they’d rather you get checked a million times than have something detrimental happen.

The Bottom Line

Listen to your body. Fatigue, indigestion or jaw pain may not seem urgent, but in the context of cardiovascular risk, they deserve attention. Early recognition can save lives. For questions or to schedule an appointment, visit Atrium Health Navicent Heart & Vascular Care or call 478-743-9762..