Heart disease symptoms can involve far more than chest pain, the most obvious.

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Heart disease symptoms can vary greatly, depending on the type of heart disease you have. Heart disease is actually an umbrella term that covers such conditions as coronary artery disease, arrhythmias, valve disease, and heart failure. Recognizing symptoms of these serious problems is critical to getting early treatment and avoiding events such as a stroke or heart attack.

Signs of heart disease aren’t always obvious, so becoming aware before trouble starts is a wise strategy.

Chest Pain

When you think of heart disease symptoms, pain or pressure in your chest may be the first example that comes to mind. If you have coronary artery disease (CAD), the arteries that supply blood to your heart muscle are narrowed—usually as a result of plaque buildup on the walls of those blood vessels.

Plaque is made up of cholesterol, fats, and other substances, and too much of it can restrict blood flow. If your heart isn’t getting as much oxygenated blood as it should, you’ll feel pain in your chest. It’s called angina, and it’s a signal that you’re at a higher risk for a heart attack.

Among heart attack signs, chest pain is the most common. It may be the only symptom you experience during a heart attack, but there are often other signs. You may also feel sick to your stomach or lightheaded or have shortness of breath.

Many people who survive heart attacks report vague feelings that something is wrong, but they can’t identify exactly what’s wrong. If you do feel chest pain, it may not seem like it’s coming from your heart.

“It doesn’t have to be right in the center of your chest; it can be elsewhere, and just a sense of something not feeling right,” says cardiologist Joy Cotton, MD, with Penn State Hershey Heart and Vascular Institute.

Palpitations

Other important heart disease symptoms to pay close attention to are palpitations or other noticeable changes in your heart rate.

A rapid heart rate or an irregular heart rate can signify an arrhythmia, which is any of several types of abnormal heart rhythms. The most common is atrial fibrillation (Afib), which occurs when the heart’s upper chambers (atria) beat in a chaotic manner, instead of a steady rhythm with the lower chambers (ventricles).

In Afib, blood doesn’t move through the heart as thoroughly and efficiently as it should, meaning blood can pool in the atria and form a clot. If this clot breaks free and travels to the brain, the result can be a stroke.

Other Heart Disease Symptoms

Many signs of heart trouble don’t emanate from the heart itself. For instance, shortness of breath can be a symptom of heart failure. If you have low blood pressure (hypotension), you may also experience shortness of breath.

Difficulty catching your breath is also one of the several heart attack signs that people ignore. They assume it’s a respiratory problem or that it’s just a harmless, but inevitable part of aging.

Fainting or lightheadedness, especially when you rise from a sitting or lying down position, can also indicate low blood pressure. If your brain isn’t getting enough oxygenated blood due to hypotension or heart failure, you may experience fuzzy thinking or have difficulty concentrating.

Swelling in your lower legs (edema) is among potentially serious heart disease symptoms. Fluid retention can indicate heart failure or problems with your leg veins.

What You Should Do

Heart disease symptoms usually develop if you have risk factors for heart disease. The main risk factors are high cholesterol, high blood pressure (hypertension), obesity, advancing age, a family history of heart disease, a sedentary lifestyle, a history of smoking or excessive alcohol consumption, and diagnosed problems such as valve disease, an arrhythmia, kidney disease, and diabetes.

If you have any of these risk factors, work with your health care provider to get them treated and under control. Some, such as age and family history, are beyond your control. But knowing that they put you at risk should prompt you to live a heart-healthy lifestyle that includes a Mediterranean-style diet, 150 minutes or more of exercise each week, no smoking, limited alcohol consumption, and sufficient sleep (seven to eight hours a night).

“It becomes vitally important to each individual to pay attention to the risk factors, then beyond that, to take action,” Dr. Cotton says. “I’m a firm believer in starting wherever you are and making that change and making that difference.”