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Signs of heart problems – Cardiovascular disease

Cardiovascular disease is the leading cause of death worldwide. Recognizing the signs of heart problems can be lifesaving. 

Cardiovascular disease is a group of diseases of the heart and the blood vessels. The terms cardiovascular disease and heart disease are interchangeable. Most of these diseases are a consequence of atherosclerosis. Atherosclerosis is the buildup of a fatty plaque in the wall of a vessel. The plaque narrows the vessel making blood flow more difficult. When a plaque breaks, it forms a blood clot that obstructs blood flow, ultimately causing an infarct.

Atherosclerosis can damage any organ in the body, in the heart atherosclerosis, causes heart attacks, in the brain it causes strokes in the kidneys it causes renal insufficiency, and so on.  

More people die of cardiovascular disease each year than from any other disease. Approximately one in every four deaths worldwide is a consequence of cardiovascular disease. The heart and the brain are the most common targets, 85% percent of cardiovascular disease deaths are due to heart attacks and strokes.

Prevention, early detection, and management can prevent most deaths. Keep reading to learn everything you need to know about recognizing cardiovascular disease signs directly from the hands of an M.D.

Can you miss the signs of heart disease and heart attack?

Probably when you hear the words heart attack, the first image that comes into your mind is a 70-year-old man with a hand over his chest complaining of shortness of breath and crushing chest pain. Many heart attacks look this way, perhaps most of them, but not all. 

Recent research has found that 45% of all heart attacks are silent. Silent heart attacks have no typical heart attack symptoms such as oppressive chest pain, shortness of breath, dizziness, and sweating. Sometimes the symptoms of a heart attack are so mild they are mistaken for something else. Some of these symptoms include:

  • Mild chest discomfort that people may confuse with heartburn or indigestion. 
  • Nausea and cold sweats
  • Dizziness 
  • Back pain 

Often, these symptoms are chalked up to the flu, stress, a bad meal, or simply feeling under the weather. 

A silent heart attack is just as damaging as a normal one. Infarction hurts and scars the heart muscle and impairs its capacity of pumping blood to the body. 

A silent infarction is a consequence of coronary artery disease, which means that people that have one are at risk of having a second, more dangerous, heart attack further along the line. Silent heart attack patients that don’t seek treatment have a three-fold risk of dying of sudden cardiac arrest. 

But what about the signs of heart failure and valve problems?

Heart attacks aren’t the only form of heart trouble.

Heart failure is the inability of the heart to pump enough blood to satisfy the body’s requirements. In fact, it is not a disease by itself, but the final consequence of many heart diseases or a transitory symptom of non-cardiac conditions. Underlying causes of heart failure include the following:

And many, many others. 

 Decompensated heart failure produces symptoms such as:

  • Shortness of breath 
  • Fatigue
  • Fluid buildup 
  • Weakness
  • Chest pain
  • Palpitations

The heart has four valves that separate the four chambers and keep blood flowing in the right direction. Valvular heart disease comes in two forms: 

  • Inability to close (valve insufficiency): Insufficiency causes blood to leak back into the heart after ejection
  • Inability to open ( valve stenosis): Stenosis prevents blood flow out of a heart chamber 

Heart valve disease can cause symptoms like: 

  • Heart failure
  • Atrial Fibrillation: A cardiac arrhythmia in which the atrium fails to contract efficiently produces an irregular heartbeat. 
  • Abnormal chest sound murmurs: Caused by irregular blood flow
  • Blood clot formation: These clots can travel through arteries to the brain and block blood flow, causing a stroke.
  • Syncope: When stenosis prevents blood from coming out of the heart, and the brain doesn’t receive enough oxygen.

There are many causes of valve disease, such as:

  • Rheumatic fever
  • Congenital heart disease
  • Coronary artery disease
  • Non-cardiac congenital conditions

What is an arrhythmia? 

Irregular heartbeats or arrhythmias are a consequence of an anomaly of the electric pathways that control the heart rhythm. In arrhythmias, the heart can beat too fast, too slow, or at a normal rate. Some arrhythmias are harmless and don’t require any treatment; others are dangerous and can produce sudden cardiac arrest and death. Palpitations, the feeling of having a fast-beating, fluttering, or pounding heart, are the most common symptoms of arrhythmia next to the syncope.

Causes of arrhythmias include:

  • Coronary heart disease
  • Heart failure
  • Congenital heart defects
  • Electrolyte imbalances

What are the warning signs and symptoms of a heart attack?

Many heart attacks start off mildly and slowly. In the early stages, you might only notice some level of discomfort before having intense symptoms. Women tend to have milder symptoms than men, the majority of silent heart attacks happen in women. People with diabetes also tend to have heart attacks without typical symptoms. 

Patients that receive treatment in the early stages tend to have better outcomes. 

Here is a list of some heart attack warning symptoms: 

  • Chest discomfort: In the early stages of a heart attack, you might only experience discomfort instead of pain. Discomfort can las last for a few minutes, go away, and then come back stronger. Discomfort may feel like fullness, tightness, or a squeezing sensation. 
  • Pain in other areas of the body: Some heart attacks produce pain in areas different from the chest. Besides the chest, commonly affected areas include the jaw, neck, back, upper abdomen, and both arms.
  • Sweat: Breaking in out in a sweat for no apparent reason is also a frequent symptom of a heart attack, particularly when it happens at the same time that any of the other symptoms.
  • Feeling lightheaded: Dizziness can be a symptom of many harmless conditions. But, combined with chest discomfort, it can also mean that your blood pressure has dropped as a result of a heart attack
  • Nausea and Vomiting

Do you know the early signs of heart disease?                                                    

Heart attack, stroke, heart failure, and chronic kidney disease are symptoms of a more significant disease called heart disease. These are late symptoms, the final consequences of years of plaque buildup. Before suffering from these life-threatening conditions, you might experience some warning symptoms that indicate heart trouble. See these early signs of heart disease as an opportunity to make lifestyle changes and seek medical help before your heart disease develops into something worse. 

Some early signs of heart disease include the following:

  • Heart Angina: Angina is probably the most direct indication that you have a heart problem (besides having an actual heart attack). Angina is the result of your heart not getting enough oxygen because of a narrow coronary artery or arteries. Heart attack and angina are just different stages of coronary artery disease. The difference is that in a heart attack, there is a complete blockage of a coronary artery. In angina, the artery is only partially blocked.   

The main symptom of angina is oppressive chest pain. The difference between angina pain and heart attack pain is that the former usually lasts less than 15 minutes, is caused by exercise or strong emotions, and subsides with rest or sublingual nitroglycerin.

  • Leg pain: Cramping calf pain when walking might be a sign you have atherosclerosis your leg arteries. If you have an atherosclerotic plaque in your legs, you likely have one in a coronary artery as well.
  • Swollen ankles: Bilaterally swollen ankles may be a consequence of fluid buildup due to congestive heart failure.
  • Shortness of breath: If you feel shortness of breath after performing everyday activities such as climbing stairs and walking moderate distances, you might be experiencing early stages of heart failure.

Are there warning signs days before a stroke?

Most strokes are the result of obstruction blood flow obstruction in the brain due to a blood clot or atherosclerosis. Strokes are a significant cause of death and disability in developed and underdeveloped countries. Most of the time, strokes occur suddenly, without warnings of any kind. However, research shows that 1 in every 8 stroke patients has a transient ischemic attack (TIA) in the days before the stroke. 

According to the American Stroke Association, a TIA, also known as a mini-stroke or warning stroke, is a transient episode of neurologic dysfunction caused by focal brain, spinal cord, or retinal ischemia without acute infarction. A TIA is a temporary lack of blood flow to the brain that results in stroke-like symptoms lasting less than 24 hours, most episodes lasting less than 10 minutes. The most frequent cause of TIA is the transitory obstruction of a brain artery by a blood clot. Less frequent causes include high blood pressure, carotid artery disease, and atherosclerosis.  

Common TIA symptoms include the following:

  • Temporary blindness in one eye (amaurosis fugax): Amaurosis fugax only involves one eye and last for seconds or several minutes.
  • Inability to speak (dysphasia): During these episodes, patients may speak incoherent words or have difficulty recalling words during the event.
  • Paralysis in one side of the face or the body (facial paralysis and hemiplegia)
  • Dizziness and vertigo 

If you have any of these symptoms, you should go to the emergency room immediately. Early initiation of stroke prevention modification therapy with aspirin and lifestyle modifications can prevent death and disability in the long run.

What are the risk factors for a heart attack?

Heart disease is mainly caused by high cholesterol and clogged arteries. However, some risk factors make it easier for cholesterol to build up an atherosclerotic plaque in an artery. Risk factors can be classified into modifiable and non-modifiable risk factors. A modifiable risk factor can be changed or managed with treatment or through lifestyle modifications (i.e., obesity). A non-modifiable factor is one that cannot be changed (i.e., male sex).

Non-modifiable risk factors include:

  • Age: The majority of people that die of coronary artery disease are 65 or older.
  • Male gender: Statistically speaking, men are at higher risk of dying from heart disease. This is probably because of the protective effects of estrogen.  
  • Family History: People whose parents suffered or died from heart disease have an increased risk of dying from coronary heart disease.

Modifiable risk factors include:

  • Smoking: Tobacco smokes damages arteries, facilitating plaque buildup. Second-hand smoking increases the coronary risk just as much as first-hand smoking does.
  • High blood cholesterol: Your blood cholesterol level is directly correlated to your risk of coronary artery disease. A healthy diet combined with cholesterol medication can help to keep your cholesterol levels in check.
  • High Blood Pressure: High blood pressure causes turbulent blood flow and increases the heart’s workload. It increases the risk of heart attack, stroke, kidney disease, and congestive heart failure. Being consistent with your hypertension medication can prevent death and disability.
  • Physical Inactivity: Regular, moderate aerobic exercise helps prevent all forms of heart disease.
  • Obesity and overweight: People with excess fat along the waist are at increased risk of developing heart disease even without other risk factors.

Can you have a heart attack without any warning signs?

Unfortunately, the answer is yes. Heart disease is a silent killer, and more often than not, it kills without any warning. However, maintaining a healthy life, managing, and controlling risk factors can go a long way in preventing a heart attack. Having a yearly check-up with a cardiologist or a general practitioner is crucial to discover and manage risk factors.

What should you do if you have any warning signs of heart disease?

If you suspect you might be having heart trouble and don’t hesitate to seek medical assistance immediately, early detection and management can significantly improve your outcome.

What’s the most common sign of heart disease?

The most common sign of a heart attack is oppressive chest pain that extends to the left arm. However, heart failure can have milder symptoms such as shortness of breath with exercise and swollen ankles that may go unnoticed.

What exams, procedures and imaging tests diagnose heart attacks?

Myocardial infarction diagnosis has three fundamental pillars: typical symptoms, electrocardiographic changes, and cardiac biomarkers. After determining the presence or absence of a heart attack with the three diagnostic components, the next step is to characterize the location and extent of the heart attack and estimate the patient’s prognosis or possible outcomes.  

The electrocardiogram is the most crucial tool in the initial evaluation of a possible heart attack. It records the electrical signals that travel through your heart. In a heart attack, the heart muscle is damaged and does not conduct electrical signals normally. These anomalies are detected by the electrocardiogram machine, which produces a characteristic tracing. Sometimes, in the early stages of a heart attack, the electrocardiogram may turn out normal. If you have typical symptoms, the ER doctor will probably repeat the test every 15 minutes for an hour before sending you home. 

Cardiac biomarkers are proteins that are usually found inside heart cells. When those cells break during a heart attack, these proteins leak into the blood and can be detected with a simple blood test. These proteins appear 3 hours after the beginning of the heart attack.

After the heart attack is diagnosed, doctors will do other tests to check out the general shape of your heart. A coronary angiogram will reveal areas of arterial blockage. An echocardiogram will reveal damaged areas of your heart, and if your heart is pumping blood effectively.

What are the warning signs of clogged arteries?

Arteries exist to carry oxygenated blood to body tissues, when arteries are healthy blood flows through them smoothly. When those arteries are clogged up with atherosclerotic plaques, blood flow becomes more difficult, and tissues receive less oxygen. Therefore, warning signs of clogged arteries are simply symptoms of a decreased blood supply to the affected tissues. Some common symptoms include:

  • Decreased pulses: A decreased, asymmetrical arterial pulse in extremities is a common symptom of peripheral artery disease. If you fell a stronger pulse in your right wrist than in your left, a plausible explanation is that there is an atherosclerotic plaque in an artery in your left arm that decreases blood flow to your left wrist. 
  • Leg Pain: Calf pain when you walk might also signify that a sick artery in your legs is unable to meet the oxygen demands of walking.
  • Erectile dysfunction: A successful erection requires increased blood flow to the penis. Although erectile dysfunction can have many causes, sometimes atheromatous plaques in the pelvis’ arteries are part of the problem.

What are the treatments and therapies for heart attacks?

After making the diagnosis, the main concern is to restore blood flow to the heart as fast as possible to prevent further damage. There are many ways to do this. Treatment varies from medication only to heart surgery. In the end, the treatment election is determined by the electrocardiographic pattern of the heart attack, and time elapsed since the beginning of the heart attack.

Based on the characteristics of the electrocardiogram, heart attacks are divided into ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI).

However, initial measures are the same for all patients. Basic measures include:

  • Oxygen administration
  • Chewable Aspirin (unless there is a clear history of allergy): Prevent new clots and prevent existing clots from getting larger
  • Sublingual nitrates: These drugs dilate arteries and improve blood flow
  • Morphine: To relieve pain
  • Statins: To control blood cholesterol levels
  • Beta-Blockers (unless there is hypotension): These medications slow down your heart rate, decreasing its work rate. 

In the case of a STEMI, doctors might choose to perform a percutaneous coronary intervention (PCI). The procedure consists of guiding a catheter through an artery in your groin to unclog a coronary artery. A metal mesh is inserted into the artery to restore blood in the long term. Heart surgery is indicated in cases of a failed PCI and cardiogenic shock.

What is cardiac rehabilitation?

Cardiac rehab is a customized therapy designed to help you recover from a heart attack and improve heart health. Cardiac rehab has three fundamental pillars:

  • Exercise counseling: Aerobic exercise is vital in cardiovascular health. Exercising right after a heart attack can be incredibly challenging. That’s why cardiac rehab involves a physical activity program tailored to the severity of your disease and your fitness level. Your therapist will continuously check your blood pressure and oxygen saturation during training sessions.
  • Education for healthy living: Managing risk factors is an integral part of heart rehab. Cardiac rehab involves knowledge about your condition and how to manage risk factors like smoking and obesity. It also includes nutrition training to help you eat a healthy diet.
  • Stress management and emotional support: Cardiac rehab programs involve access to counseling and peer to peer support groups. Focusing on the emotional part of having a heart problem is essential. Stress hurts your heart; tackling your daily stress sources is an important part of regaining your health.

Cardiac rehab prevents future cardiovascular problems, like second heart attacks, strokes, and kidney disease. People who attend cardiac rehab programs have more success controlling heart risk factors and living healthy lives. Research shows that people who go to cardiac rehab have a 25 % less chance of dying and 30% less fatal heart events.

What happens if a heart attack goes untreated?

Symptomatic heart attacks receive the treatment most of the time. Almost half of the heart attacks go undetected and do not receive treatment. Without reperfusion therapy, heart damage is more extensive. Months or years later, the heart will give out. It won’t be able to keep meet the body’s oxygen need. That’s when heart failure happens.

In other cases, the first asymptomatic heart attack will be followed by a second heart attack. This second heart attack will be more severe than the first one with the potential of causing cardiac arrest.

What can you do if you are presenting symptoms or have risk factors?

This tool is a cardiovascular disease symptoms checker. It has the most critical risk factors, signs, and symptoms of cardiovascular disease. Therefore, it would aid in identifying people at high risk of having this condition, in order to prevent future complications. It is free, and it would only take a few minutes.

What do you think?

Written by Dr. Esteban Kosak

Doctor of Medicine - MD Recently Graduated from Medical School and inspired to aid the global population during this situation. I think that we shall no longer be waiting to see a doctor when we feel sick. Several times we feel disease searches in Google drive us to a rabbit hole and come out thinking that we may die of cancer or something very serious, given that symptoms may seem to fit a wide variety of illnesses. Since I recently graduated from medical school. I have all the medical information fresh in my mind. My thorough experience as an expert researcher allows me to very-well known the different diseases and conditions that affect human bodies. Empowered by the United Nations 17 Sustainable Development Goals (SGDs). I think that we all can provide a grain of sand to help humanity. That's why we created Symptoms.Care a place where you can come and screen your symptoms and find what different illnesses can be related to them. Armed with the right information you can instantly, discretely, secure and from the comfort of your home talk with a Doctor that can Evaluate your Symptoms and help you seek the right treatment.

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