Could I have had a silent heart attack?

DEAR DOCTOR K: I recently had an ECG in preparation for a surgical procedure. The doctor said it showed I'd had a silent heart attack. How could I have had a heart attack and not known about it?
DEAR READER: I know it sounds strange. After all, on television, heart attacks are portrayed in rather dramatic fashion. Typically, you see a person clutching their chest with agonizing pain. This mental image is embedded in our culture. But my colleague, Dr. Deepak Bhatt, a cardiologist at Harvard-affiliated Brigham and Women's Hospital, cites a recent study that is the latest to show that heart attacks often can be "silent."