On television, a character experiencing a heart attack might dramatically clutch their chest, exclaim in pain, and fall to the floor. In real life, a heart attack can sometimes appear that way, but in many cases, it will look quite different from what you expect.

In fact, a “silent” heart attack can go virtually unnoticed or produce only mild symptoms. Because silent heart attacks actually account for 20 percent of all heart attack events, it’s important to learn the subtle signs of one.

The following symptoms can be signs of a silent heart attack, and can be easily mistaken for something much more mundane:

• • Shortness of breath
  • General state of discomfort
  • Inability to sleep
  • Nausea
  • Sweating
  • Dizziness
  • Pain in the shoulder and neck
  • A feeling of unease

Sometimes, those who suffer silent heart attacks write off their symptoms as indigestion, fatigue, or “just feeling run down”. But if these symptoms appear suddenly without any clear explanation, you should talk to your doctor about them right away. This is especially true if the symptoms worsen when you get up and move around; that’s a sign that making your heart work harder is increasing your symptoms.

Anyone can suffer a heart attack, silent or not, but let’s review the risk factors that make you more likely to experience a cardiac event:

• • Age (over 45 for men, and over 55 for women)
  • Overweight
  • You have diabetes
  • High blood pressure
  • High cholesterol
  • Sedentary lifestyle
  • Tobacco use
  • Family history of heart disease
  • You’ve suffered a prior heart attack

Some people who suffer a silent heart attack only discover the event years later, during a procedure such as an EKG. If you’ve noticed a faster heart rate or intolerance to exercise, these could be signs that you have previously suffered a silent heart attack.

Because silent heart attacks can increase your risk of cardiac failure in the future, it’s important to assess whether you’ve experienced one. Talk to your doctor about any unusual symptoms, so that they can assess your overall heart health and make appropriate recommendations for your situation.