Can a Heart Attack Occur Without Chest Pain?

How many times have you seen this act on TV? The character on the screen gets a glazed look in his eyes, stumbles, and clutches his chest as he slowly (and dramatically) falls to the ground. This is the classic Hollywood depiction of a heart attack. And while this scenario might accurately describe some heart attacks, it's not representative. In fact, the notion that severe chest pain must indicate a heart attack, or a heart attack must come with severe chest pain, is not always true.

A recent study published in the Annals of Internal Medicine reports that chest pain severity is not an indicator of who is having, or is likely to have, a heart attack. Patient history and cardiovascular risk factors are better indicators than pain score.

What is a heart attack?

When a blockage limits the supply of blood and oxygen to the heart, it can cause a heart attack, or myocardial infarction. Clots develop when fat and other substances accumulate in the coronary artery, which supplies crucial blood and oxygen to the heart. If not treated right away, damaged heart muscles can die.

Symptoms of a heart attack

Chest pain is the number one reason people visit the emergency room and the most common heart attack symptom. The pain can be severe, but can just as likely start slowly as mild pain or discomfort; it may even come and go. When severe, patients describe it as a crushing or searing pain that radiates to the back, neck, jaw, shoulders and arms, especially the left arm. The researchers in this new study believe the brain may interpret signals from the heart as pain located elsewhere, or as other health problems caused by a damaged heart.

Heart attacks are the leading cause of death in the U.S. They do not discriminate, and women are just as likely to have a heart attack as men are. While chest pain may not indicate a heart attack, it is a sign that something is wrong. You should seek immediate emergency medical care in case you are having a heart attack. About half the deaths from heart attacks occur within an hour of the start of symptoms and before people reach the hospital. Time is of the essence.

Be aware of the other symptoms of heart attacks as well. In addition to chest pain, patients may experience shortness of breath, nausea, vomiting, faintness, sweating, dizziness, or unexplained pain that's not in the chest.



Busko, Marlene. " Chest Pain Severity Not a Telltale Sign for MI." Medscape Medical News. Web. 29 July 2011.

Mayo Clinic. "Chest pain." Web. 11 February 2011.

National Heart, Lung and Blood Institute. "Heart Attacks." Web.