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Eight symptoms of heart disease that you're probably unaware of

Not all signs are as obvious as severe chest pain. Two top cardiologists tell Lisa Salmon about some of the more subtle indicators

Crucial signs: chest pain can be a sign of heart disease
Crucial signs: chest pain can be a sign of heart disease

By Lisa Salmon

Most people know chest pain can be a sign of heart disease - but it isn't necessarily the only warning sign that something might be wrong.

There are many other - often more subtle - symptoms that can sometimes indicate heart disease, which, generally speaking, involves narrowed or blocked blood vessels that can lead to a heart attack, angina or stroke.

Ahead of World Heart Day on September 29, here, two eminent consultant cardiologists - Professors Simon Redwood and Anthony Mathur - outline eight lesser-known heart disease symptoms that everyone should be aware of...

1. Fatigue

Prof Redwood, a cardiologist at London Bridge Hospital, says: "There are many different reasons why you might feel fatigued, so heart disease shouldn't be your first thought every time you feel a little tired. However, it's important to be mindful a constant or chronic fatigue could signal heart disease - or even a heart attack.

"This symptom is quite common in women and occurs due to the extra stress that's put on the heart while it's trying to pump blood around the body if an area of blood-flow is blocked. If you've noticed a dip in your energy or you feel very fatigued throughout the day despite a good amount of rest and little exertion, I recommend you see your GP to check for the trigger - and hopefully rule out heart disease."

2. Shortness of breath

Prof Mathur, a cardiologist at the Heart Cells Foundation, says: "Many people are surprised to learn that their heart and lungs are very closely linked. The heart pumps oxygen-poor blood from the body to the lungs for cleaning and re-oxygenating. Once the blood is re-oxygenated, the heart then pumps the blood back around the body, giving each part the oxygen it needs to function. Therefore, you can feel short of breath if your heart isn't able to pump blood effectively.

"If you're suffering from shortness of breath and fatigue, this could be due to a condition stopping your heart from pumping blood efficiently, like heart disease. Getting disproportionately short of breath for the activity you're doing - such as walking to the car or bringing in the shopping - could be a warning sign you shouldn't ignore."

3. Light-headedness

"Light-headedness is very common and rarely a cause for concern," says Prof Redwood. "It can be brought on by a number of things, such as physical exertion, tiredness, anxiety, colds or flu or other infections and much more.

"However, if you start feeling light-headed when you carry out everyday actions, such as standing up or taking a short walk, I would advise you book an appointment with you GP or a heart specialist. Heart problems such as heart disease can trigger light-headedness or dizziness because of a decrease in blood volume, which causes an inadequate blood-flow to your brain or inner ear."

4. Neck, jaw and back pain

"When there's a problem with the heart, it can affect the nerves in the chest, which is why many heart conditions cause chest pain," explains Prof Mathur. "However, the chest isn't the only part of the body where pain can manifest. In some cases, heart disease sufferers may experience pain in the jaw, back or arms. This pain can often be hard to pinpoint, as there are no specific muscles or joints that ache - but it may be exacerbated with exertion and settled with rest. If you notice these symptoms, I would recommend seeing a GP, just to be on the safe side."

5. Swollen feet or ankles

Prof Redwood says: "Edema is a medical term used to describe excess fluid building up in the body's tissues. It can affect any part of the body but in someone with heart disease, it most commonly manifests in the legs, ankles or feet. This is because if you're experiencing a heart failure, one or both of your heart's lower chambers may have lost its ability to pump blood effectively. As a result, blood can pool in your legs, ankles and feet. Edema in these areas could be the result of a number of different conditions, such as cirrhosis, kidney disease, kidney damage, weakness, damage to the veins in your legs or an inadequate lymphatic system - so seeking medical support is important for a number of reasons."

6. Nausea or vomiting

"Many people have reported experiencing mild indigestion, or other gastrointestinal problems before or during a heart attack," warns Prof Mathur. "However, as this can be a difficult symptom to pick up on, it's often dismissed as heartburn. If you experience ongoing, abnormal indigestion, such as nausea or vomiting with no apparent cause, this could be a sign heart disease is present."

7. Neck circumference

"Waist size is often associated with heart disease risk, but many people are surprised to learn that neck circumference can also have significance when it comes to heart disease," Prof Redwood points out. "A neck circumference of 16in or greater for men, and 13in or greater for women, can indicate a higher likelihood of elevated blood pressure, high triglycerides and low 'good' cholesterol."

8. Sweating

"Sweating more than usual can be an early warning sign of heart disease," says Prof Mathur. "During exertion, clogged arteries make it more difficult for your heart to pump blood, which causes your body to produce more sweat in an attempt to keep your temperature down. If you experience unusual episodes of excessive sweating it may be worth considering seeing your GP for advice."

For more information, see world-heart-federation.org/world-heart-day

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