Many people associate heart disease with obvious symptoms, such as chest pain. But there are less obvious links, like swollen feet or bleeding gums, that also warrant a heart exam by your doctor.
The classic warning signs of a heart attack are familiar to anyone who has watched medical dramas on television. The patient, usually an elderly man, begins to wheeze and gasp. Then he tightens his chest, staggers and finally collapses. In reality, the signs and symptoms of heart disease are much more varied and subtle.
While age is a risk factor for heart disease, it can occur at any age. In fact, heart attack hospitalizations among young people between the ages of 35 and 54 have increased over the past few decades, particularly among women, according to a 2019 study published in the journal Circulation. High risk rates for heart disease, including obesity and high blood pressure, in this age group put them at higher risk, according to the Centers for Disease Control and Prevention (CDC).
Signs and symptoms of heart disease
First, some definitions. Symptoms of heart disease are indications you feel or experience, while a sign of heart disease is something your doctor can see or find. The obvious symptoms of heart disease are shortness of breath and chest pain. But your doctor will also look for common signs of heart disease during an exam or interview with the patient.
It is important to know the signs of heart disease because they can appear before the common symptoms of the disease. By telling your doctor about these warning signs, you can benefit from early treatment for heart disease.
1 Swelling of the feet and lower legs
Fluid retention in the feet and legs is known as peripheral edema. Edema can show up as “sock marks” on the legs and ankles at the end of the day, especially if you are wearing tight socks or tights. Mild peripheral edema is common. Your doctor can check for this sign by pressing a finger on your ankle or shin to see if there is a depression or lump. This is called “pitting edema,” which could indicate congestive heart failure. Edema can be a sign of heart failure because when the heart is not pumping well, fluid in the blood vessels tends to leak into surrounding tissue. The legs and ankles are common areas of edema due to the effects of gravity.
Leg swelling can also be due to venous insufficiency or varicose veins. This happens when the veins in the legs do not return blood to the heart normally and can lead to a feeling of heaviness or swelling in the leg. If a leg is swollen or asymmetrical, with sudden pain and tenderness behind the calves or thigh, this may indicate a blood clot, which is serious and requires immediate medical attention.
Since edema can be a sign of various conditions, it is always a good idea to consult your doctor in the event of the appearance or worsening of swelling in the legs. Treatment depends on the cause of the edema but can often be managed with medication or lifestyle changes.
2 Male pattern baldness
Some research has linked androgenic alopecia, a common form of hair loss, to heart disease in men. This type of hair loss in men is called male pattern baldness. An oft-cited study published in 2000 in the journal JAMA Internal Medicine found that men whose hair falls on the top of their head have an increased risk of heart disease by about 23% compared to men with full hair. Men who completely lose their hair on the top of their head have a 36% increased risk, according to the report.
A more recent study, published in June 2021 in the International Journal of General Medicine, linked baldness to heart disease in Chinese men. Four hundred and two participants aged 28 to 75 with varying levels of hair loss underwent tests to determine the health of their arteries. The researchers found that the strongest link to heart disease was in men whose hair loss was severe and early on.
However, experts say it’s important to note that other factors may be at play. Some researchers speculate that this link may be due to excess testosterone, the male hormone, which interferes with growth. hair on the head and causes hardening of the arteries. However, the definitive answer has not yet been provided. This doesn’t mean you’re doomed to heart disease if you’re bald, but it may suggest that you should be examined more carefully for other signs and symptoms of heart disease.
3 Yellow bumps on the skin
Xanthomas are fatty deposits that accumulate under the skin. They can appear as small yellow bumps or large, flat patches on the elbows, knees, hands, feet, or buttocks. A type of xanthoma called xanthelasma palpebrarum appears on the eyelids. These yellow fat deposits can potentially be signs of heart disease. Xanthomas can be a marker of very high cholesterol levels in the bloodstream. This phenomenon is associated with heart disease because the deposits can also accumulate inside the arteries of the heart.
4 Gum disease
Swollen, sore, or bleeding gums are usually a sign of poor oral hygiene, but they can also be a strong sign of heart disease. People with gum disease are two to three times more likely to have heart disease, but it’s not yet known if there’s a direct link.
Some research, including a study published in January 2021 in the Journal of Periodontology, supports the theory that inflammation may be behind this association. Patients with periodontal or gingival inflammation often present with an inflammatory process that may be related to heart disease. The same inflammatory process in the gums can cause a similar buildup of deposits in the arteries or heart. Another hypothesis is that the bacteria in the gums that cause periodontal disease can travel to the body’s blood vessels where they cause inflammation or damage.
But other research suggests that gum disease and heart disease may occur together due to a third factor: smoking. A 2018 study published in the European Journal of Preventive Cardiology included data on nearly one million people who suffered nearly 65,000 cardiovascular events, including heart attacks. The researchers found a moderate link between poor oral health and heart disease, but after controlling for smoking status, the link was no longer significant.
5 Emotional stress
Weakening of the heart muscle accompanied by extreme emotional stress, grief, or loss, especially in women, is called takotsubo cardiomyopathy, or broken heart syndrome. In this case, the surge of stress hormones, especially adrenaline, triggers heart pain much like a heart attack, often accompanied by palpitations, shortness of breath, and flushing. The difference between stress-induced cardiomyopathy and heart attack is that the coronary arteries are not significantly blocked. A sharp rush of adrenaline is thought to “stress” the heart muscle and cause this dysfunction. Broken heart syndrome was first described in the medical literature in a 2005 study published in the New England Journal of Medicine.
Recent research, published in October 2021 in the Journal of the American Heart Association, revealed an alarming increase in cases of takotsubo cardiomyopathy in older women. According to the study, 88% of people with broken heart syndrome are women, and rates are 6 to 12 times higher in women aged 50 to 75. According to the American Heart Association, people who survive the initial stage can recover within weeks, but the long-term effects of broken heart syndrome are still being studied.
6 Signs of Heart Failure
Heart failure means the heart is not working as well as it should. This does not mean that the heart is failing. Another term for heart failure is congestive heart failure (CHF). First of all, it is important to understand that heart failure is a spectrum and that many patients with imperfect heart function can actually feel very well. It is also important to remember that early signs of heart failure may go unnoticed as they may be subtle.
Heart failure gets progressively worse over time. The warning signs can be the following
If your heart begins to fail and fluid begins to build up in your tissues, causing edema, you may experience sudden weight gain.
Change in exercise tolerance
If you notice a noticeable change in your ability to exercise or exercise, this may be a warning sign of heart failure. The reason for this is that the pumping function of the heart is impaired and you cannot increase the supply of oxygen to the tissues as efficiently as before, which results in shortness of breath.
Heart failure can cause decreased blood flow to the kidneys, which causes increased fluid retention. One of the signs of this fluid retention can be frequent urination.
In heart failure, there is often an accumulation of fluid in the chest, which can make it difficult to lie down due to shortness of breath. This can manifest as a nocturnal cough.
Remember that all of these signs of heart disease can have many different causes. They do not mean that you have or will have heart disease. But combined with other signs and symptoms of heart disease, your blood tests, and your family history, they give your doctor the best chance of detecting heart disease early and keeping you healthy.