Silent heart disease is a dangerous condition that can happen when you develop coronary artery disease (CAD) without noticing any symptoms. Because you don’t have any signs of a heart problem, you might not realize you have a heart condition at all until you have a heart attack or stroke.
"With silent heart disease, you can have major blockages in the arteries of your heart without typical symptoms like chest pain, shortness of breath or decreased endurance," said Sahil Agrawal, MD, a cardiologist with Banner Health.
How silent heart disease happens
This disease develops like other forms of heart disease. It just doesn’t have any obvious symptoms.
"Blockages develop in the arteries of the heart from a buildup of plaque or cholesterol deposits," Dr. Agrawal said. Those blockages mean your heart doesn’t get enough blood flow.
Why are there no symptoms?
With silent heart disease, your heart works harder to make up for the reduced blood flow. It may also adapt to the reduced blood flow by developing new pathways, which are called collateral circulation.
If your heart works harder and adapts, it can cover up possible warning signs until a blockage causes a heart attack. "Symptoms may not develop if blockages are not severe enough or because of an inactive lifestyle," Dr. Agrawal said. And if you have subtle signs like fatigue or mild discomfort you might mistake them for aging or stress.
Who is at risk for silent heart disease?
You’re at risk for silent heart disease if you’re at risk for heart disease. Factors that increase your risk include:
- High blood pressure: This condition strains your heart and damages arteries.
- High cholesterol: This condition increases plaque buildup in your arteries.
- Diabetes: Diabetes affects your blood vessels and raises your heart disease risk.
- Smoking: Smoking damages your blood vessels and decreases your oxygen levels.
- Obesity: Too much body weight stresses your heart and plays a role in high blood pressure and diabetes.
- Lack of exercise: A sedentary lifestyle weakens your heart and may lead to poor circulation.
- Family history: Genetic factors can increase your risk.
- Age and gender: Men over 45 and women over 55 are at higher risk.
How silent heart disease leads to sudden heart attacks
"A heart attack occurs when a plaque becomes unstable, breaks open and spills its fatty contents into the artery. This triggers a blood clot to form, which reduces the supply of blood to the heart's muscle, causing a heart attack," Dr. Agrawal said.
Since silent heart disease often goes undetected, people may not take precautions like lifestyle changes or medication that could prevent a cardiac event.
How to detect silent heart disease
Because there are no symptoms, routine health screenings are important. "Silent heart disease can be detected with various noninvasive tests. Your cardiologist will determine which test is best for you," Dr. Agrawal said.
Talk to your health care provider about:
- Blood pressure, cholesterol and blood sugar checks: These routine tests check for key risk factors for heart disease.
- Electrocardiogram (ECG or EKG): This test identifies irregular heart rhythms.
- Stress tests: These check how well your heart functions under exertion.
- Coronary artery calcium scoring: This test measures plaque buildup.
- CT scans or echocardiograms: These advanced imaging tests show detailed pictures of the heart.
“In some cases, an invasive procedure called an angiogram might be necessary,” Dr. Agrawal said.
Preventing and managing silent heart disease
Heart disease is a leading cause of death worldwide. Even if you feel healthy, good habits can reduce your risk.
"The best way to lower your risk of silent heart disease is with good lifestyle choices," Dr. Agrawal said. Try to follow these tips:
- Quit smoking: Smoking is one of the biggest risk factors for heart disease.
- Eat a balanced diet: Focus on whole grains, lean proteins, fruits, vegetables and healthy fats. The Mediterranean and DASH diets are good options.
- Exercise regularly: Aim for 150 minutes of moderate exercise per week.
- Maintain a healthy weight: Losing even 5% to 10% of your body weight can improve your heart health.
- Manage stress: Practice mindfulness, yoga, meditation or deep breathing.
- Limit alcohol consumption: Too much alcohol raises your blood pressure and increases your heart disease risk.
- Follow your provider’s advice: If you have high blood pressure, diabetes or high cholesterol, take your medications as prescribed to help maintain good control.
When to see a provider
Even without symptoms, regular checkups can help detect silent heart disease early. Seek medical advice if you notice:
- Frequent fatigue or shortness of breath
- Dizziness or lightheadedness
- Unexplained nausea or indigestion
- Discomfort in the jaw, back or arms
These signs may not seem like heart attack symptoms but they could point to a hidden heart problem.
The bottom line
Silent heart disease occurs when you don’t have any symptoms of heart disease. It can be life-threatening since it can cause a heart attack or stroke. Early detection and lifestyle changes make a difference.
To find out if you’re at risk for silent heart disease, contact your health care provider or an expert at Banner Health. Taking steps now can help protect your heart for the future.
