# Silent myocardial infarction: ARIC cohort links it to roughly threefold higher cardiac death risk

- Published: 2026-11-08 20:17 UTC
- Section: Life & Health › Medicine
- Tags: silent myocardial infarction, silent heart attack, ARIC study, cardiac death risk, Rotterdam Study, cardiac MRI, troponin, electrocardiogram, unrecognized heart attack
- URL: https://realtech.media/news/rt-a35d857cda24d87abac852fb_silent_myocardial_infarction/

**In the US ARIC study, 317 silent and 386 symptomatic heart attacks occurred; silent ones carried about three times the risk of cardiac death.**

![Silent myocardial infarction: ARIC cohort links it to roughly threefold higher cardiac death risk](https://realtech.media/media/2026/11/2380dd7732f7da67.webp)
*ad-hoc-news.de*

Silent myocardial infarctions often occur without the classic chest pain and go unnoticed, ad-hoc-news.de reports, summarizing several studies on their causes, risk factors and detection. [1] According to Professor Antonio Bartorelli, nearly half of all heart attacks go unnoticed, and many patients are diagnosed only after considerable damage to the heart muscle. [1] Harvard University data indicate that half of heart attack patients currently have a silent one, with middle-aged men affected more often. [1]

## Figures from cohort studies

The US ARIC study followed 9,498 middle-aged people for an average of nine years. It recorded 386 symptomatic and 317 silent heart attacks, so about 45 percent were silent. [1] In silent cases the risk of cardiac death was about three times higher and the risk of death from all causes about 34 percent higher. [1]

A 2026 analysis of the Rotterdam Study covered 12,303 participants and found 669 recognized and 512 unrecognized heart attacks. [1] In Finnish autopsy data, about 42 percent of 3,122 people who died of sudden cardiac death showed traces of an earlier silent infarction. [1] Publications such as JAMA Cardiology note that silent infarctions are in the long term as dangerous as recognized ones. [1]

In another study of 2,000 men and women aged 45 to 84 without prior cardiovascular problems, 8 percent had an infarct scar on cardiac MRI after ten years without having noticed the event. Men in this group had a silent infarction five times more often than women. [1]

## Symptoms, risk groups and diagnosis

Dr. David Morrow of Brigham and Women's Hospital explains that some patients do feel symptoms but do not attribute them to the heart. [1] Indigestion and muscle pain are among the most common misinterpretations. Signs listed for a silent course include unexplained weakness, shortness of breath, cold sweat, nausea, numbness in the arms, heartburn, and pain in the back, jaw or neck. [1]

In diabetics, neuropathy often reduces pain perception, which raises the risk of unnoticed infarction. [1] Other groups named are people with hypertension, high cholesterol, overweight or low physical activity, smokers, people under chronic stress or with a genetic predisposition, women after menopause and people over 65. [1]

A past silent infarction is usually identified by electrocardiogram through a characteristic signature. Other methods include echocardiography, cardiac MRI and blood tests for troponin. [1] A clinically detectable infarction requires reduced blood flow lasting 15 to 30 minutes. [1]

## Sources

1. [ad-hoc-news.de](https://www.ad-hoc-news.de/wissenschaft/stiller-herzinfarkt-risiko-fuer-kardialen-tod-ist-rund-dreimal-hoeher/70478032)

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Source: RealTech, realtech.media — https://realtech.media/news/rt-a35d857cda24d87abac852fb_silent_myocardial_infarction/