Why is heart disease so deadly? One reason is that many people are slow to
seek help when symptoms arise. Yes, someone gripped by sudden chest pain probably knows to
call 911. But heart symptoms are not always intense or obvious, and they vary
from person to person and according to gender.
Because it can be hard to make sense of heart symptoms, doctors warn against
ignoring possible warning signs, toughing them out, waiting to see if they go
away, or being quick to blame them on heartburn, muscle soreness, or other less
serious, non-cardiac causes. That's especially true for men and people over 65,
as well as for people with other cardiac risk factors, such as high cholesterol or blood pressure, obesity,
smoking, diabetes, or a family history of heart disease.
"The more risk factors you have, the higher the likelihood that a symptom
means something is going on with your heart," says David Frid, MD, a
cardiologist at the Cleveland Clinic. "People often don't want to admit that
they're old enough or sick enough to have heart trouble. Putting off treatment
for other medical problems might not be so bad, but a serious heart problem can
mean sudden death. It's better to go in and get it evaluated than to be
12 Possible Heart Symptoms Never to Ignore
Here are a dozen symptoms that may signal heart trouble.
Heart attack can cause intense anxiety or a fear of
death. Heart attack survivors often talk about having experienced a sense of
2. Chest discomfort.
Pain in the chest is the classic symptom of
heart attack, and "the No. 1 symptom that we typically look for," says
Jean C. McSweeney, PhD, RN, associate dean for research at the University of
Arkansas for Medical Sciences College of Nursing in Little Rock and a pioneer
in research on heart symptoms in women. But not all heart attacks cause chest
pain, and chest pain can stem from ailments that have nothing to do with the
Heart-related chest pain is often centered under the breastbone, perhaps a
little to the left of center. The pain has been likened to "an elephant sitting
on the chest," but it can also be an uncomfortable sensation of pressure,
squeezing, or fullness. "It's not unusual for women to describe the pain as a
minor ache," McSweeney says. "Some women say the pain wasn't bad enough even to
take a Tylenol."
Women, more so than men, can also experience a burning sensation in their
chest, rather than a pressure or pain. "Sometimes people make the mistake
that the pain comes from a stomach problem," says Nieca Goldberg, MD, clinical
associate professor of medicine at the NYU Langone Medical Center in New York
City and another expert on women's heart symptoms.
Persistent coughing or wheezing can be a symptom of heart
failure -- a result of fluid accumulation in the lungs. In some cases, people
with heart failure cough up bloody
can cause lightheadedness and loss of consciousness. So can potentially
dangerous heart rhythm abnormalities known as arrhythmias.
Especially among women, unusual fatigue can occur during
a heart attack as well as in the days and weeks leading up to one. And feeling
tired all the time may be a symptom of heart failure.
Of course, you can also feel tired or fatigued for other reasons. How can
you tell heart-related fatigue from other types of fatigue?
"If you don't feel well and all the wind is knocked out of your sails, don't
try to figure it out on the Internet or from a book," says Goldberg.
"Wasting time is dangerous."
6. Nausea or lack of appetite.
It's not uncommon for people to feel
sick to their stomach or throw up during a heart attack. And abdominal swelling
associated with heart failure can interfere with appetite.
7. Pain in other parts of the body.
In many heart attacks, pain
begins in the chest and spreads to the shoulders, arms, elbows, back, neck,
jaw, or abdomen. But sometimes there is no chest pain -- just pain in these
other body areas. The pain might come and go.
Men having a heart attack often feel pain in the left arm. In women, the
pain is more likely to be felt in both arms, or between the shoulder
8. Rapid or irregular pulse.
Doctors say that there's nothing
worrisome about an occasional skipped heartbeat. But a rapid or irregular pulse
-- especially when accompanied by weakness, dizziness, or shortness of breath
-- can be evidence of a heart attack, heart failure, or an arrhythmia. Left untreated,
some arrhythmias can lead to stroke, heart failure, or sudden death.
9. Shortness of breath.
People who feel winded at rest or with
minimal exertion might have a pulmonary condition like asthma or chronic
obstructive pulmonary disease (COPD). But breathlessness could also indicate a
heart attack or heart failure.
"Sometimes people having a heart attack don't have chest pressure or pain
but feel extremely short of breath," Goldberg says. "It's like they've just run
a marathon when they haven't even moved." During a heart attack, shortness of
breath often accompanies chest discomfort, but it can also occur before or
without chest discomfort.
Breaking out in a cold sweat is a common symptom of
heart attack. "You might just be sitting in a chair when all of a sudden you
are really sweating like you had just worked out," Frid says.
Heart failure can cause fluid to accumulate in the
body. This can cause swelling (often in the feet, ankles, legs, or abdomen) as
well as sudden weight gain and sometimes
a loss of appetite.
12. Weakness. In the days leading up to a heart attack, as well as
during one, some people experience severe, unexplained weakness. "One woman
told me it felt like she couldn't hold a piece of paper between her fingers,"