Almost 50 percent of people who have heart attacks have silent heart attacks, they don’t realize at the time that an attack is happening. The evidence shows up later on with an EKG or blood test. The patient might have a high pain tolerance and not notice the pain. Pain can also be located away from the chest such as the wrist or jawline. It’s important to know that especially in an older patient, shortness of breath, fatigue, dizziness, weakness , nausea or vomiting and back it jaw pain can indicate a silent heart attack is occurring.