You’ve probably heard the phrase “mild heart attack.” While it certainly beats having a “major” heart attack, it’s something you definitely don’t want to brush aside.

In other words, a small heart attack is nothing to ignore. (Clinicians generally say “mini-heart attack" or “mild heart attack.” They mean the same thing.)

Dr. Gocha Saliashvili

Heart health should be a priority for all of us. Cardiac issues are all too common; every 40 seconds in America, someone has a heart attack.

We spoke to cardiologist Dr. Gocha Saliashvili of Novant Health Cardiology - Greensboro about the signs and symptoms (there may not be any!), what to do if you suspect you’re having one and how to prevent them in the first place.

At Novant Health, we provide some of the nation's best individualized heart and vascular care, conveniently located, and focused on you.

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What exactly constitutes a mild heart attack?

With a mild heart attack, there’s partial – rather than a total – blockage of a coronary artery or blockage in a very small coronary artery. Mild heart attacks lead to less damage to the heart muscle. Patients may even be asymptomatic. They may not know they’ve had a minor heart attack – but may find out later once they have a bigger heart attack.

There are two types of minor heart attacks:

  • Non-ST elevation myocardial infarction (NSTEMI) happens when there’s a partial blockage of blood flow through one of the major coronary arteries. That blockage reduces the supply of oxygenated blood getting to the heart muscle. This type of heart attack doesn’t typically do extensive damage to the heart muscle, although it could. It’s different from a STEMI heart attack, which can happen when there’s a full blockage. That is a life-threating emergency requiring emergent intervention ASAP; every minute matters.
  • Silent myocardial infarction (SMI) is sometimes referred to as a “silent heart attack” because its symptoms range from non-existent to minor and short-lived. Many people who have an SMI don’t realize they’ve had a heart attack.

A mild heart attack is still serious, right?

Yes. Even though the damage may be minor, it doesn't mean the patient is free and clear. The patient still needs to be admitted to the hospital and evaluated for coronary artery disease. Talking to a doctor – and following their recommendations – can decrease that patient’s risk of future heart attacks. And that’s important, because once you've had one heart attack, the likelihood you’ll have another increases.

How much damage could a mild heart attack do to the heart muscle?

They don’t often cause significant damage, but they can lead to cardiac issues – some severe – later in life. Some of the damage may be permanent, but the overall damage could be so minor that it doesn’t affect heart function at all.

Arrhythmia – an irregular or abnormal heartbeat – is one risk. These arrhythmias may be noted as palpitations – heart racing or fluttering or skipped beats. When a physician suspects arrhythmia, the first step toward a diagnosis is usually sending the patient for an electrocardiogram, or EKG. Some patients need to have cardiac monitors to discover arrhythmias.

Who’s at risk of a mild heart attack? Is it the same group at risk for a bigger heart attack?

Yes. Smokers; people who are sedentary, obese and overweight; those with diabetes, high blood pressure, high cholesterol. And you can’t ignore family history. Even when following all the healthy heart guidelines, someone with a family history of heart disease – especially when the onset of heart disease was at a young age – is at greater risk of a heart attack than someone who doesn’t have that history.

What are the symptoms of a mild heart attack? Are they the same ones associated with severe heart attacks?

They can be the same, but less intense. The most common symptom, present in more than 90% of patients, is chest pain – tightness, pressure, heaviness. Other symptoms include shortness of breath, lightheadedness, fatigue, even nausea and vomiting. But sometimes, patients have no chest pain. As I said, mild heart attacks can occur without any symptoms at all.

If somebody does experience any of those symptoms, what do they need to do – get to the ER as fast as possible, I assume?

They need to call 911 and be transferred to the ER without delay. If they have symptoms of a heart attack, they should not drive themselves or be driven by family members or friends. They need an ambulance.

What are the dangers of ignoring symptoms?

Even mild heart attacks can get complicated, and those complications could be severe. Another big risk is that you could have a more severe heart attack the next time. It is dangerous to ignore any sign of heart disease. I think it bears repeating: Once you’ve had one heart attack, your risk of having another increases.

What preventive measures can people take – the same ones you’d take to reduce the risk of a severe heart attack?

Yes, the same ones, such as maintaining a healthy weight, staying active, not smoking, managing blood pressure, cholesterol and stress. And, of course, eating a healthy diet. The Mediterranean diet – which is heavy in plant-based foods, whole grains and healthy fats like olive oil – is the best diet for the prevention of heart disease – and it’s effective for weight loss, too.

Exercise is important for heart health, too. We all need about 150 minutes or more each week of cardio. That can include walking, riding a bike – even a stationary one, using an elliptical machine or swimming.

And if you’re a smoker, talk to your doctor about cessation programs. There are supportive programs that can help you quit. Prevention is the best thing you can do for your health. It’s always easier to prevent a disease than it is to treat it.

Learn more about heart health at the American Heart Association’s website,