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All Possible Heart Disease Symptoms you shouldn’t Ignore

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Heart Disease Symptoms
Contents

OVERVIEW

Cardiovascular diseases give rise to a relatively limited range of symptoms. To reach the correct diagnosis, a doctor carefully looks at what triggers the symptoms, their subtle differences, and how the patient describes them.

Many heart symptoms are closely tied to exertion: they appear or get worse with physical activity. The exact symptoms depend on which disease is present. The main ones are chest pain (often brought on by exertion), fainting (syncope), breathlessness, palpitations, and severe, prolonged chest pain.

This article is general information, not a diagnosis. If you think you may be having a heart attack, call 911 right away, even if you're not sure.

heart Disease Symptoms

MOST COMMON HEART DISEASE SYMPTOMS

  • Chest pain on physical work: People with coronary heart disease often get chest pain during physical effort. Chest pain has other causes too. Heart-related pain is typically a pressing, squeezing or crushing feeling in the center of the chest that can spread to the left arm, shoulder, neck or jaw. In stable angina it usually fades within about five minutes with rest or medicine; in a heart attack it does not go away. A full history is crucial in deciding whether chest pain comes from the heart or from another cause.
  • Severe prolonged pain in the chest: Severe chest pain that lasts longer than a few minutes, or goes away and comes back, may be acute coronary syndrome: unstable angina or a heart attack (myocardial infarction). Some people have a history of stable angina that changes pattern, starting to occur with less effort or at rest. Anyone with this kind of pain needs emergency care: call 911 rather than driving to the hospital.
  • Loss of consciousness: When some heart conditions reduce blood flow to the brain, a person can faint. This is called syncope. It happens because of decreased blood flow (perfusion) to the brain.
  • Breathlessness: Cardiac causes of breathlessness include acute coronary syndrome, valvular heart diseases, pericarditis, cardiomyopathy, and acute or chronic heart failure. Breathlessness also has many noncardiac causes, so it should be investigated properly to find the cause and treat it.
  • Palpitations: Palpitations are a common symptom of heart rhythm problems. They mean you notice your own heartbeat, which may feel fast, pounding, fluttering or irregular. The feeling can trigger anxiety. Palpitations can also occur with other conditions, such as an overactive thyroid, anxiety or fever.

Women, older adults and people with diabetes may have less typical heart attack symptoms. These include unusual fatigue lasting days, nausea, shortness of breath, or pain in the back, jaw or upper abdomen, as the NHLBI's list of heart attack symptoms explains.

STABLE ANGINA PECTORIS:

Stable angina is chest pain caused by reduced blood flow to the heart muscle (myocardial ischemia), usually from a fixed narrowing of the coronary arteries. It typically lasts a few minutes, often five minutes or less, and is relieved by rest or nitrate medicine. It is brought on by physical exertion, cold, emotional stress or heavy meals. The pain can spread to the left arm, jaw and neck and may come with nausea, sweating and lightheadedness.

ACUTE CORONARY SYNDROME (ACS):

Acute coronary syndrome is a term that describes:

  • unstable angina
  • Non-ST-elevation myocardial infarction (NSTEMI)
  • ST-elevation myocardial infarction (STEMI)

ACS usually happens when a fatty plaque in a coronary artery breaks open and a blood clot forms on top of it, suddenly narrowing or blocking the artery. The main feature is chest pain behind the breastbone that can spread to the arms, neck and jaw. It may come with vomiting, sweating, fainting and difficulty breathing.

The pain is more severe and lasts longer than stable angina, which usually eases within minutes. Unstable angina may last longer than 20 minutes, come back, or occur at rest. The pain is squeezing or pressing and is not relieved by rest or nitrates.

Heart Disease Symptoms of Congestive Cardiac Failure

Congestive cardiac failure is a condition in which the heart cannot pump enough blood to meet the body's needs. Left-sided heart failure is the most common type. Its main symptoms are shortness of breath, fatigue and weakness, and swelling from fluid buildup, rather than chest pain.

Shortness of breath is often worse with activity and when lying flat (orthopnea). Lying flat feels better when the head is raised on pillows. Paroxysmal nocturnal dyspnea is a sudden attack of severe breathlessness that wakes a person from sleep with anxiety and a feeling of suffocation; sitting up helps. Right heart failure causes swelling of the legs and abdomen, an enlarged liver, and swollen neck veins.

ATRIAL FIBRILLATION:

Atrial fibrillation is the most common sustained heart rhythm problem (arrhythmia). In an arrhythmia, the heart cannot maintain its normal sinus rhythm. In atrial fibrillation, chaotic electrical signals fire throughout the upper chambers (atria), causing an irregular pulse and palpitations. When you check the pulse, it is "irregularly irregular."

Common causes and triggers include high blood pressure, coronary artery disease including heart attack, heart valve disease such as rheumatic heart disease, an overactive thyroid, pulmonary embolism, and severe infection (sepsis). A proper investigation and patient history are needed to find the cause.

PULMONARY EDEMA:

Pulmonary edema, fluid in the lungs, is one of the most serious complications of heart failure. It happens when pressure in the lung's blood vessels rises and pushes fluid into the air sacs. The main symptoms are sudden shortness of breath, rapid breathing, crackling or wheezing sounds while breathing, and a drop in blood oxygen levels. It is a medical emergency.

MITRAL STENOSIS:

Mitral stenosis is a narrowing of the mitral valve opening. The narrowing reduces blood flow from the left atrium into the left ventricle, so the left atrium enlarges. The most common symptom is difficulty breathing on exertion. Fatigue is also common because the heart pumps out less blood.

An enlarged left atrium can press on the esophagus and cause difficulty swallowing (dysphagia). It can also press on a nerve to the voice box and cause hoarseness. Stretching of the atrial walls can trigger atrial fibrillation, which causes palpitations.

MITRAL REGURGITATION:

Mitral regurgitation means the mitral valve does not close tightly, so blood leaks backward into the left atrium when the heart contracts (systole). In the US, common causes include mitral valve prolapse and age-related valve degeneration; worldwide, rheumatic heart disease is a major cause.

Sudden (acute) mitral regurgitation can cause pulmonary edema and low blood pressure. When it develops slowly, the left atrium gradually enlarges and a person may have no symptoms for years. Later, it can lead to breathlessness, fatigue and heart failure.

MITRAL VALVE PROLAPSE:

In mitral valve prolapse, the valve flaps bulge back into the left atrium when the heart contracts, which can let some blood leak backward. Many people with mitral valve prolapse have no symptoms and don't know they have it. When symptoms occur, they can include chest pain not caused by coronary disease, palpitations, dizziness, fatigue, shortness of breath and panic attacks.

AORTIC STENOSIS:

Aortic stenosis is a common valve disease, mainly in older adults. It is a narrowing of the aortic valve that blocks blood flow from the left ventricle into the aorta. Over time, the left ventricle thickens (left ventricular hypertrophy). The most common cause is calcium buildup on the valve with age; a valve with two flaps instead of three (bicuspid aortic valve), present from birth, makes this happen sooner.

Many people have no symptoms until the disease is advanced. Typical symptoms are chest pain or pressure with activity, shortness of breath on exertion, fatigue, palpitations, and dizziness or fainting during activity. Severe untreated aortic stenosis can cause sudden cardiac death.

AORTIC REGURGITATION:

Aortic regurgitation is backward leakage of blood from the aorta into the left ventricle while the heart relaxes (diastole), because the aortic valve does not close properly. Causes include a widened (dilated) aortic root and damaged valve flaps. A common infectious cause is infective endocarditis.

Sudden (acute) aortic regurgitation can cause severe breathlessness, pulmonary edema and cardiogenic shock. When the disease is chronic, a person may have no symptoms for many years until the left ventricle weakens and heart failure develops.

TRICUSPID VALVULAR DISEASE:

Tricuspid valve disease mainly causes signs of right-sided congestion: swollen neck veins (raised jugular venous pressure), swelling of the legs and abdomen, and fatigue. A doctor may hear a murmur at the lower left edge of the breastbone. Tricuspid regurgitation, a leaky tricuspid valve, causes a murmur throughout the heartbeat (pansystolic murmur) in the same area.

HYPERTROPHIC CARDIOMYOPATHY (HCM):

Hypertrophic cardiomyopathy is an inherited condition in which the heart muscle becomes abnormally thick. It is usually caused by mutations in genes for the heart's contractile proteins (sarcomere genes). Symptoms include breathlessness on exertion, chest pain with exertion, palpitations from arrhythmias, and fainting. Many people have few or no symptoms.

HCM is a leading cause of sudden cardiac death in young athletes, and sometimes that is the first sign of the disease. A doctor may hear a murmur caused by blockage of blood flow out of the left ventricle. Some people also have mitral regurgitation because the thickened heart pulls the mitral valve out of position.

HEART DISEASE SYMPTOMS OF PERICARDITIS:

Pericarditis is inflammation of the sac around the heart (pericardium). The main symptom is sharp, stabbing chest pain that can spread to the neck, shoulder or back. The pain gets worse with deep breathing, coughing and lying flat, and gets better when sitting up and leaning forward. A doctor may hear a scratchy "friction rub" through a stethoscope.

PERICARDIAL EFFUSION AND CARDIAC TEMPONADE:

Pericardial effusion is a buildup of fluid in the sac around the heart. Cardiac tamponade happens when that fluid squeezes the heart so it cannot fill properly, which is an emergency. Its classic signs are low blood pressure, muffled heart sounds and swollen neck veins (raised JVP). Another sign is pulsus paradoxus, a drop in systolic blood pressure of more than 10 mmHg when breathing in. As the effusion grows, tamponade symptoms such as breathlessness and lightheadedness become more evident.

AORTIC DISSECTION:

Aortic dissection is a tear in the inner layer (intima) of the aorta. Blood surges through the tear into the middle layer (tunica media) and splits the wall into two layers. The main symptom of aortic dissection is sudden, severe chest or upper back pain, often described as tearing or ripping.

Other features can include unequal pulses or blood pressure between the arms, fainting, stroke-like symptoms, low blood pressure and shock. It is a life-threatening emergency.

CONCLUSION:

Across heart conditions, the main symptoms are chest pain or pressure, difficulty breathing, fainting, palpitations, fatigue and swelling. Sudden cardiac death can be the first sign in some people. Call 911 for chest pain that lasts more than a few minutes or doesn't ease with rest. For other symptoms, see a doctor promptly so they can find the cause and recommend the right treatment.

Sources

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