Warning signs and symptoms of heart disease (2024)

Chestpainis discomfort or pain that you feel along the front of your body, between (and including) your neck and upper abdomen. There are many causes of chest pain that have nothing to do with your heart.

But chest pain is still the most common symptom of poor blood flow to the heart or a heart attack. This type of chest pain is calledangina.

Chest pain can occur if the heart does not get enough blood or oxygen. The amount and type of pain can vary from person to person. The intensity of the pain is not always related to the severity of the heart problem.

• Some people may feel a crushing pain, while others experience only mild discomfort.
• Your chest may feel heavy or as if someone is squeezing your chest or heart. You may also feel a sharp, burning pain in your chest.
• You may feel the pain under your breastbone (so the pain is called substernal) or in the neck, arms, stomach, jaw or upper back.
• Chest pain from angina often occurs with activity or emotion and resolves with rest or a medication called nitroglycerin.
• Indigestion can also cause chest pain.

Women, older adults, and people with diabetes may have little or no chest pain. Some people have symptoms other than chest pain, such as:

• Fatigue
• Shortness of breath
• General weakness
• Change in skin color or grayish pallor (episodes of change in skin color associated with weakness)

Other symptoms of a heart attack may include:

• Extreme fear
• Fainting or loss of consciousness
• Stiffness or dizziness
• Nausea or vomiting
• Palpitations (the feeling that your heart is beating too fast, too hard, or irregularly)
• Shortness of breath
• The sweat, which can be very heavy

When the heart can't pump blood as well as it should, blood pools in the veins that go from the lungs to the heart. Fluid leaks into the lungs and causes shortness of breath. This is a symptom ofheart failure.

You may become short of breath:

• During activity
• While you rest
• If you lie flat on your back, it can even wake you from your sleep

Coughing or wheezing that doesn't go away could be a sign that fluid is building up in your lungs. You may also cough up mucus that is pink or bloody.

Swelling (edema) in your lower legs is another sign of a heart problem. When your heart doesn't work as well, blood flow slows and returns to the veins in your legs. This causes fluid to build up in your tissues.

You may also have swelling in your stomach or notice some weight gain.

Narrowing of the blood vessels that carry blood to other parts of the body is not the same as heart disease, but it can mean that you are at much greater risk of a heart attack than you would otherwise be. It can occur when cholesterol and other fatty material (plaque) build up on the walls of your blood vessels.

Poor blood supply to the legscan lead to:

• Pain, tenderness, fatigue, burning, or discomfort in the muscles of your feet, calves, or thighs.
• Symptoms that often occur while walking or exercising and disappear after a few minutes of rest.
• Numbness in your legs or feet when you are at rest. Your legs may also feel cool and the skin may look pale.

A stroke occurs when blood flow to part of the brain stops. A stroke is sometimes called a 'brain attack'. Symptoms of a stroke may include difficulty moving the limbs on one side of the body, drooping on one side of the face, loss of sensation on one side of the body, difficulty speaking or understanding language.

Fatigue can have many causes. Sometimes it simply means you need more rest. But feeling exhausted could be a sign of a more serious problem. Fatigue can be a sign of heart problems if:

• You feel much more tired than usual. It is common for women to feel severely fatigued before or during a heart attack.
• You feel so tired that you cannot perform your normal daily activities.
• You have sudden, severe weakness.

If your heart can't pump blood as well, it may beat faster to try to keep up. You may feel your heart beating or pounding. A fast or irregular heartbeat can also be a sign of thisarrhythmias. This is a problem with your heart rate or rhythm.

If you show signs of heart disease, contact your doctor immediately. Don't wait to see if the symptoms go away or dismiss them as nothing.

Call 911 or your local emergency number if:

• You have chest pain or other symptoms of a heart attack
• You know that you have angina pectoris and have chest pain that does not go away after 5 minutes of rest or after taking nitroglycerin
• You think you are having a heart attack
• You become extremely short of breath
• You think you have lost consciousness

Goff DC Jr, Lloyd-Jones DM, Bennett G, et al. 2013 ACC/AHA guideline on cardiovascular risk assessment: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.Circulation. 2014;129(25 supplement 2):S49-S73. PMID: 24222018pubmed.ncbi.nlm.nih.gov/24222018/.

Gulati M, Bairey MerzCN. Cardiovascular disease in women. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds.Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th Edition Philadelphia, PA: Elsevier; 2022: Chapter 91.

Morrow DA, de Lemos J. Stable ischemic heart disease. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds.Braunwald's heart disease: a textbook of cardiovascular medicine.12th Edition Philadelphia, PA: Elsevier; 2022: Chapter 40.

Writing committee members; Lawton JS, Tamis-Holland JE, Bangalore S, et al. 2021 ACC/AHA/SCAI guideline for coronary artery revascularization.J Am Coll Cardiool. 2022,79 (2): e21–e129. PMID: 34895950pubmed.ncbi.nlm.nih.gov/34895950/.

Last revised: 10/26/2022

Updated by: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and A.D.A.M. Editorial.