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Heart disease is the leading cause of death in the U.S., so it’s important that you can recognize the signs of a heart problem. Symptoms of heart disease, also called coronary artery disease (CAD), abnormal heart rhythms (arrhythmias), and heart failure sometimes overlap. But if you’re at risk for any of these conditions, you should pay close to attention to the most significant and serious heart problem symptoms.
1. Chest Pain
Chest pain is probably the most recognizable symptom of CAD. Chest pain caused by narrowed coronary arteries is also called angina, and it’s often the first sign of heart attack. However, you can have chest pain and not be having a heart attack. There are different types of angina that are signs of CAD and reminders that you need to take your heart health seriously.
Chest pain that develops with exertion, but fades with rest is called stable angina. It’s predictable and only presents itself when the heart is called up upon to work extra hard. A more dangerous type of chest pain is unstable angina. It’s the same kind of pressure in the chest, but it can show up at any time. You might be taking a walk or watching TV and suddenly you feel pressure in your chest. People with unstable angina are at a higher risk of a heart attack than those with stable angina.
Chest pain that may be a heart problem symptom will feel noticeably different from a pulled muscle or heartburn from indigestion. Angina often feels like pressure or a squeezing sensation in the chest, rather than an ache or soreness that you might feel after a big workout.
If you ever experience chest pain, describe your symptoms to your doctor. Explain how long the pain lasts, what (if anything) makes it go away, when you started having chest pain, and whether there other symptoms along with it. You should also be able to describe the nature of the pain itself (pressure, sharp, ache, comes and goes, etc.)
Chest pain may be the most alarming heart problem symptom, but it’s by no means the only one that makes you take notice that all is not right with your heart.
Heart palpitations usually aren’t a sign of heart attack. But they can be a symptom of an abnormal heart rhythm or arrhythmia. Arrhythmias can be mild and may never bother you. But they can also be quite serious and require medications or procedures designed to prevent episodes when your heart isn’t beating normally.
One of the most common arrhythmias is atrial fibrillation or afib. Afib is a problem with the nerves in your heart’s two upper chambers—the atria. Instead of a synchronized, steady heart rate, people with afib experience a quivering or chaotic beating of their atria. If you have afib, you may notice an unsteady heartbeat or even a racing heart.
The risk with afib is that circulation can be compromised so blood doesn’t circulate as properly as it did to all your organs and tissue. Blood can also pool in the atria, causing a blood clot to develop. A clot that forms in the atria poses a stroke risk, because it could travel to the brain and block blood flow to brain tissue.
In addition to afib there are several other types of arrhythmias that can cause palpitations. You could have one of several forms of tachycardia, an unusually rapid heartbeat. Or it could be a type of bradycardia, an unusually slow heartbeat. While bradycardia may have the same fluttering or rapid heartbeat we associate with palpitations, any change from the normal, steady heart rate is worth getting checked out.
You should also know that palpitations can simply be a result of stress or anxiety, and not necessarily a heart problem symptom. Smoking can lead to palpitations, as can certain cold medicines or other drugs.
As with chest pain, palpitations in any form should also be evaluated by a doctor. Even if the abnormal rhythms don’t cause you any problems with your quality of life or your daily functioning, you should still have them checked out. An early diagnosis of a potentially serious problem often leads to a better outcome.
3. Shortness of Breath
Trouble catching your breath, even with mild exertion like climbing one flight of stairs, can be a sign of several different health problems. And it can certainly be a sign of heart attack.
Other conditions marked by shortness of breath are heart failure, heart attack or low blood pressure (hypotension). If you have trouble breathing when you’re lying down, it can be a sign of heart failure. That’s because fluid in the lungs that builds up because of poor circulation can spread out in the lungs, making it difficult to breathe normally.
But shortness of breath isn’t always a heart problem symptom. As you can imagine, it can also be related to respiratory health. Conditions ranging from allergies to pneumonia can leave you straining to catch your next breath.
If you notice that lately you’re short of breath, tell your doctor. A comprehensive physical, with a focus on your lungs and heart will start to reveal just what is keeping you from inhaling and exhaling with ease.
If your primary heart problem symptoms include dizziness or even fainting, you may be suffering from hypotension. Fainting due a drop in blood pressure is a condition known as syncope, and while it’s not necessarily life threatening, it can still be quite dangerous. Fainting can result in injury if you fall.
Heart failure is also a cause of lightheadedness or dizziness. A heart attack or stroke can also leave you feeling woozy in the head.
Lightheadedness or dizziness can also sometimes occur if you take blood pressure-lowering medications. These drugs can cause a sudden drop in blood pressure, meaning the brain isn’t getting the usual healthy circulation that keeps everything working optimally.
Dizziness can also be a product of an inner ear problem or low blood sugar. Iron-poor blood (anemia) can also lead to dizziness. If you’re unsure as to what causes you to have dizzy spells, see your doctor. Reporting a symptom as seemingly harmless as a little dizziness might be just the thing that helps you and your physician uncover a more serious underlying heart problem.
Heart problem symptoms such as chest pain, palpitations, shortness of breath, or lightheadedness may not always signify a major problem, but they’re four important signs that something about your health may need a closer look.
Originally published in 2016 and regularly updated.