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Nearly half of all heart attacks occur without you even knowing it

People who experienced a silent heart attack were 34 percent more likely to die prematurely of any cause

Nearly half of all heart attacks occur without you even knowing it

It can leave lasting damage even if you didn’t realize you had one

A heart attack might not hurt as much as you think—in fact, you might not even know you had one, according to research from the Wake Forest School of Medicine.

In the study, researchers added up the number of clinically-diagnosed heart attacks and “silent” heart attacks—events that were undiagnosed at the time but were confirmed by electrocardiogram (EKG) afterwards—that occurred in more than 9,000 people during a 9-year follow up.

They discovered that 45 percent of all the heart attacks were silent.

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But even though the heart attacks go unrecognized, that doesn’t mean they’re harmless.

People who experienced a silent heart attack were 34 percent more likely to die prematurely of any cause than those who didn’t have the problem, the study found.

The increased risk of death comes in part from the heart attack itself, which damages your heart muscles, says Timothy Byrne, M.D., the executive director of cardiac services at Abrazo Arizona Heart Hospital.

Without proper post-attack care, that damage could lead to another event—and most likely, it’s one you’d definitely feel.

Additionally, risk factors like smoking, poor diet, high blood pressure, or high cholesterol may have kicked off the silent heart attack in the first place, says Dr. Byrne. Those could come back to bite you again.

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Your move? Find out what’s going on in your chest now so you’re not taken by surprise later.

Once you hit 40—or 35 if you have risk factors like other health problems or a family history of heart attack—it’s a good idea to get a stress test for your heart, which includes an EKG, says Dr. Byrne.

This will help your doctor figure out how your heart is functioning, and can also detect past damage.

If tests reveal a silent heart attack, you can work on preventive strategies like eating better, exercising more, and quitting smoking, Dr. Byrne says.

Your doctor might also prescribe heart meds to help reduce your risk, too.

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