What is a silent angina attack?

A special problem happens when coronary heart disease is present but does not cause any chest discomfort at all. These "silent" attacks can be as serious and dangerous as those with chest discomfort even though there are no special warning signs. In other words, complications of heart attack, irregular heart beat and even death can happen in these cases, as well. Silent attacks can happen during activity and can happen even at rest.

Some researchers have found that most daily angina attacks are actually silent. These often happen when a patient with coronary heart disease is not physically active, but may be under emotional stress. For example, cigarette smoking has also been found to trigger silent angina attacks in patients who have coronary heart disease. These can be detected when monitoring the heart's response to cigarettes.

Researchers have found that silent angina attacks are more common in the morning hours, which is the same time when blood pressure and heart rate are both higher.  It may be that the higher blood pressure and heart rate increase the heart's demand for more blood supply.  When there is not enough blood supply, the angina happens, but it may be "silent" without chest discomfort.

The exact reasons that some persons do not feel any chest discomfort with angina attacks are not known. Since these can be as dangerous as those with chest pain, it makes it even more important that any unusual feelings not be ignored--proper testing and diagnosis could be lifesaving.