If the importance of heart health isn’t already perfectly clear, let this one statistic do the heavy lifting for you — at over 600,000 fatalities per year, heart disease is the #1 cause of death in the United States. Paying attention to your heart’s heath is one of the most important ways to ensure your wellbeing to live a long and happy life.
Let’s discuss the signs of an unhealthy heart so we can learn to spot them—in ourselves, our loved ones, our friends and colleagues—and take corrective action.
Types of major heart diseases
To understand the signs and symptoms of heart disease, it helps to know what diseases we are talking about. Heart disease is a blanket category that describes a number of discrete medical conditions. Here are the different kinds of heart disease that the below symptoms might be a sign of:
Aorta Disease and Marfan Syndrome
The aorta is a large artery, leaving the heart directly and supplying oxygenated blood to much of the body. Aorta disease, including the genetic disorder Marfan Syndrome, causes the aorta to widen or tear. This can cause high blood pressure, connective tissue disorders, hardened arteries (atherosclerosis), and serious aortic injury.
A ruptured aorta can lead to significant internal bleeding and sudden death, with little prior warning and even in patients with few symptoms.
Arrhythmia is an abnormal heart rhythm. A healthy heart beats between 60 and 100 times per minute at a remarkably regular clip. The heart rate can increase or decrease based on levels of stress or physical activity, but a healthy heart keeps a steady beat commensurate with the body’s level of exertion.
The heartbeat is actually triggered by an electrical impulse sent by the brain. An arrhythmia is produced by an interruption or irregularity in that electrical system. A doctor might diagnose heart arrhythmia if the heart beats irregularly (uneven intervals between beats) or if the heart beats too fast or too slow at rest. Arrhythmia can cause sudden cardiac arrest and lead to death, but can often be treated with medication or with surgical implants like pacemakers.
Cardiomyopathies describe swelling, thickening, and enlargement of the heart. This may restrict the ability of the heart to beat efficiently. Cardiomyopathy may worsen over time and lead to arrhythmias or heart failure. It may be caused by congenital factors or by lifestyle factors like metabolic diseases like diabetes.
Congenital Heart Disease
Congenital conditions are defects that develop in fetuses before birth. A congenital heart condition may affect the heart or blood vessels in any number of ways and may require surgery to prolong the life of the infant.
About 8 in 1,000 infants suffer from congenital heart defects. The cause is not well understood but may relate to genetic factors, as well as lifestyle factors on the part of the parents.
Coronary Artery Disease
Coronary artery disease (CAD) occurs when the coronary arteries harden or become clogged with plaque. This is known as atherosclerosis and can happen to any blood vessel, but the coronary arteries are a special case. They are the blood vessels on the outside of the heart which provide the heart muscle itself with food, oxygen, water, and nutrients.
Impingement of the coronary arteries can cause the heart to starve, resulting in arrhythmia and heart attack.
Deep Vein Thrombosis and Pulmonary Embolism
Deep vein thrombosis occurs when a blood clot forms in the deep veins. They most commonly form in the legs or hips and can cause swelling and redness.
Sometimes the blood clot breaks loose, travels through the circulatory system, and reaches the lungs, creating a blockage. This condition is known as a pulmonary embolism, and it can be life-threatening. Pregnancy and certain hormone therapies can increase the risk of both conditions, as can staying seated for too long.
“Heart failure” is not the same thing as a stopped heart. The medical term for that is cardiac arrest. “Heart failure” merely refers to the heart failing to pump strongly or efficiently, usually due to prolonged deterioration of the heart muscle due to other conditions.
Heart failure affects 6.5 million people and is predicted to be 46% more prevalent by 2030, according to the American Heart Association. More people over the age of 65 are hospitalized due to heart failure than any other reason.
Heart Valve Disease
The heart is divided into four chambers. Valves block the entrances and exits of each chamber, making sure blood flows in the right direction at the right time. Several conditions can interrupt this process, including narrowing of the aortic valve (aortic stenosis).
Other forms of heart valve disease include mitral valve insufficiency, which can cause blood to backflow and build up fluid in the lungs, or mitral valve prolapse, where the mitral valve doesn’t close correctly. Issues and insufficiencies can occur in other heart valves as well.
The heart is surrounded by a fibrous sac known as the pericardium. If the pericardium becomes inflamed (pericarditis), it can lead to a sudden onset of chest pain, dizziness, and other symptoms. It is often caused by an infection.
Pericarditis affects about 3 in 10,000 people per year, making it one of the least common causes of chest pain.
Rheumatic Heart Disease
Untreated strep throat may lead to rheumatic fever, an inflammatory disease that may affect the heart, as well as the brain, skin, and joints. Rheumatic heart disease usually occurs after numerous involvements of the heart in the fever, at which point the heart valves may be damaged, leading to heart failure or fibrillation.
11 Common signs of an unhealthy heart
The public face of an unhealthy heart is often a dramatic incident—EMTs charging defibrillators and shouting “CLEAR!” A rush to a hospital with an oxygen mask put over the face, possibly a rib cracker being wielded later to operate.
Actually, the early signs of an unhealthy heart are much less dramatic--but learning to spot them can enable patients to take early action and prevent one of those hospital-show action beats.
Here are eleven common signs to watch out for, any or all of which may indicate an unhealthy heart. No matter how mild or inconsequential they seem, they could be harbingers of future cardiac trouble if you don’t nip it in the bud:
1. Shortness of breath
Besides the heartbeat, the involuntary inhaling and exhaling of the lungs goes unnoticed by most people when it is working properly. When it stops working properly, however, it becomes very noticeable. Shortness of breath is the sensation of not being able to breathe efficiently. The lungs may feel heavy, or the patient may feel compelled to breath rapidly and shallowly.
Shortness of breath may result from anxiety, anemia, or allergic reactions, but the underlying cause is usually pulmonary (lungs) or cardiac (heart) in nature. A dangerous pulmonary embolism may first reveal itself through a sudden shortness of breath.
Other times, shortness of breath develops gradually. It may be a sign of aortic disease, arrhythmia, or heart failure.
Whether sudden or gradual, shortness of breath is never a symptom to take lightly.
2. Chest discomfort
Also known as angina, chest discomfort is one of the more obvious signifiers of an unhealthy heart, since the heart is located in the chest. If a person feels pressure, pain, pinching, or burning in the chest, the heart is a likely culprit.
Fleeting pain, pain that seems to be on the surface, or pains that worsens when touched, are all less likely to indicate a heart condition. The pain to look for lasts several minutes, doesn’t change with external pressure, and may occur either at rest or during physical exertion. Even if the pain is not severe, it may indicate serious heart trouble and needs to be followed up on.
3. Left shoulder pain
Interestingly, the nerves in the left arm and the nerves in the heart send messages to the same pain centers of the brain. Therefore, the brain may interpret heart trouble as pain in the left arm or shoulder.
This is known as referred pain, and just because it isn’t in the chest doesn’t mean it is unrelated to the heart, or that the specific issue is located in the shoulder. In fact, pain or pressure in the left shoulder is a classic signifier of an unhealthy heart.
A person should seek medical attention immediately if they experience sustained pain or pressure in the left arm or shoulder, especially if it is accompanied by other signs of heart distress, like shortness of breath.
4. Irregular heartbeat
As noted above, an irregular heartbeat actually is a kind of heart disease in and of itself—an arrhythmia. Not all arrhythmias are dangerous or an indication of a serious heart condition, but enough of them are that even mild arrhythmias should be taken seriously.
Some forms of arrhythmia may be easily noticeable. There are many kinds of arrhythmias to be aware of; some, but certainly not all, to look out for include:
- Atrial Fibrillation. If the electrical regulation of the heart fails, the heart may beat far faster than normal, up to 300 beats per minute. People with atrial fibrillation are at high risk of stroke.
- Atrial Flutter. Another form of fast heartbeat, not as intense but still a major risk factor for stroke.
- Premature Ventricular Contractions. If your heart “skips a beat” frequently, it may indicate heart disease.
- Ventricular Fibrillation. When the electrical signals from your brain to the ventricles become garbled, your heart’s ventricles squeeze irregularly and ineffectively. This is highly dangerous and requires immediate assistance.
5. Heartburn or stomach pain
Women need to be especially careful of persistent heartburn or stomach pain. Many factors cause these conditions, but for reasons not fully understood, women have a much higher propensity to manifest heart trouble as heartburn or stomach pain, up to and including early warning signs of a heart attack. The condition may worsen and spread to involve the chest or left shoulder, more classic indicators of an unhealthy heart.
Women should be especially careful if they have recurrent stomach conditions like nausea, acid reflux, GERD, indigestion, bloating, or abdominal pain. Yes, there could be many causes, but the possibility that this is a gender-specific indicator of heart trouble should not be discounted.
6. Swollen feet
Swollen feet may be a sign of deep vein thrombosis, which may be a precursor to a pulmonary embolism. It may also be an indicator of heart failure. This is because as the heart begins to pump efficiently, gravity starts to pool the blood closer to your lower extremities throughout the day.
If your shoes or pants start to feel tight as the day comes to an end, the possibility of heart failure should be considered. The next sign may be a blood clot leading to a heart attack or cardiac arrest.
It’s counter-intuitive—we associate exercise with a healthy heart. But remember, a sedentary lifestyle is a risk factor for heart disease, not a one-to-one correlation. Heart disease can and does happen to people with active lifestyles and vigorous exercise routines. Change in your body’s tolerance to exercise may be a useful early warning sign of oncoming heart failure.
Watch out for fatigue or reductions in your strength and endurance when you work out, as well as other signs like dizziness, chest discomfort, nausea, or shortness of breath. Excessive sweating may also be a sign of brewing heart trouble, especially an unusually cold sweat.
8. Sexual health problems
Erectile dysfunctions can have many causes and are effectively treated by medication. However, men, especially men with other risk factors like diabetes, excess body weight, family history, and other symptoms, should consider the possibility that problems “performing” may be an early sign of coronary artery disease.
One of the first symptoms of coronary heart disease is a different ED—endothelial dysfunction, which means the blood vessels cannot dilate properly. It’s not uncommon for this effect to strike the erectile function of the penis first. By all means treat the symptom, but consider the possibility that heart disease might be the real culprit, not a flagging libido.
9. Feeling dizzy or lightheaded
Feelings of dizziness and lightheadedness usually indicate a lack of oxygen flowing to the brain—a circumstance that could lead to stroke. If the brain doesn’t have enough oxygen flowing to it, the culprit could be a lack of blood-flow to the brain or diminished oxygenation of the blood.
This could be a result of atherosclerosis, valve disorders, or heart failure. Dizziness when standing up is a common symptom of heart disease, since gravity pulls blood closer to the ground and the heart must work harder to pump it to the head than to the feet. If the heart can’t work that hard, dizziness and lightheadedness are an early indication that something is wrong.
10. Sleep apnea
Sleep apnea is a condition in which your breathing stops and restarts intermittently during sleep. It is commonly associated with snoring, but not every case of sleep apnea coincides with snoring, and not everyone who snores has sleep apnea. Sleep apnea can be life-threatening if it causes a catastrophic loss of oxygen.
Many conditions can cause sleep apnea, including age, obesity, diabetes, and abuse of alcohol or some prescription drugs. However, it could also be caused by heart failure, which could impede brain functions like the involuntary breathing reflex. People with sleep apnea should get their heart health checked.
11. Constant fatigue
Many conditions can cause fatigue, like the flu or bacterial infections. However, fatigue is a classic sign of heart failure as the body becomes deprived of oxygen. Be especially on the lookout for sudden or gradual increase in the difficulty of daily tasks that used to be easy.
What to do if you have one or more of these symptoms
The most important thing to do if you have any of these symptoms is to get tested for indicators of heart health. It might seem far-fetched, but this is definitely a case of “better safe than sorry.” Even people with lifestyle habits conducive to heart health may be especially susceptible to heart disease due to genetics or other factors, and early detection may be key to applying the proper treatment.
You don’t even have to make a doctor’s appointment to at least get the ball rolling. For example, the imaware™ Baseline Heart Health home test is an affordable, user-friendly test that arrives confidentially in the mail and is supplied with an easy-to-use home blood-collection kit, as well as bio-bags and postage-paid shipping containers to return your blood cards to the lab for testing.
Once the lab analyzes your blood sample, it returns a report that measures seven key markers of heart health:
- HS-CRP. High-sensitivity C-reactive protein increases in the presence of inflammation. Excess hs-CRP may be a warning sign of coronary artery disease.
- Total Cholesterol. Excess total cholesterol is a warning sign for heart disease.
- Glucose. High blood glucose can damage the heart and blood vessels, acting as a precursor to heart disease.
- Triglycerides. Triglycerides are fatty cells. Too many of them may be a sign of thickening of arterial walls or obstructed blood flow.
- LDL-C. LDL-C is the “bad” cholesterol, which builds up in arteries and obstructs blood flow.
- HDL-C. Just as excess “bad” cholesterol could be a sign of poor heart health, a deficit of “good” HDL cholesterol could indicate a problem.
- HbAc1. Excess levels of hemoglobin AC-1 may be an indicator of several heart conditions.
If any of these indicators fall outside of ‘normal’ ranges, further testing may be recommended by your general practitioner or a specialist. All test results are reviewed by a doctor, and FSA and HSA cards are accepted.
While waiting for your test results, follow-up appointment, or if you just want to make some lifestyle adjustments to reduce your risk for this #1 killer, here are several things you can do to boost your heart health.
5 Ways to keep a healthy heart
1. Drink plenty of water
Optimal hydration helps your heart do its job, while dehydration causes unnecessary strain on your heart. Since your blood is mostly made of water, when you become dehydrated the volume of your blood decreases and is adversely impacted by sodium, which makes it harder for the heart to distribute oxygenated, nutrient-rich blood throughout the body. This can lead to an elevated heart rate and exacerbate any heart conditions that may already exist.
Received wisdom recommends eight cups of water per day, but the National Academies of Science, Engineering, and Medicine actually recommend over 11 cups for women and over 15 cups for men, per day. Actual water requirements will vary by activity level, climate, exposure to sun, and body weight.
2. Exercise regularly
A sedentary lifestyle (i.e., one that includes little or no exercise) has been shown to double the risk of heart disease. Even thirty minutes per day of low-impact exercise can dramatically improve your heart health, as well as ameliorate risk factors for heart disease like obesity, excess body weight, high blood pressure, and improve blood cholesterol levels.
Remember, the heart is a muscle. Just as lifting weights causes the muscles in your arms, legs, and trunk to strengthen and become more durable, cardiovascular exertion through jogging, biking, swimming, or rowing can strengthen the heart muscle, increasing its ability to do its job.
3. Reduce alcohol intake
Some studies show that moderate alcohol intake actually benefits heart health, but the American Heart Association is not convinced. Excessive alcohol consumption is hard on the heart, and, as well, exacerbates risk factors like excess body weight. When mixed with certain other drugs, especially stimulants, alcohol can lead to catastrophic heart failure.
The AHA recommends no more than one alcoholic drink per day for women, no more than two for men. In the opinion of the AHA, the less alcohol, the better.
4. Monitor & control your cholesterol & blood pressure
High blood pressure and bad cholesterol levels (high LDL, low HDL) are major risk factors of heart disease. High blood pressure may be controlled through diet and exercise. A doctor may prescribe certain medications to get it under control.
Healthy cholesterol levels strongly correlate with diet. Saturated fat, abundant in processed foods, tends to increase LDL cholesterol levels, filling the blood with sticky substances that restrict blood flow. Choosing fresh food, minimally processed, with few added sugars or sauces, an abundance of vegetables, and “good” unsaturated fats (found in plants and seafood) is the way to go to control cholesterol.
5. Take heart health supplements
Diet and exercise will go a long way, but certain vitamins, minerals, and other substances are known to contribute to heart health. You can buttress your help by supplementing your diet with concentrated formulations of these substances. Note that supplementation is not a substitute for improvements to diet and physical activity levels if changes are needed. And it’s widely recommended that as much as possible you get as many of these substances from diet.
- Omega 3 Fatty Acids. Omega 3 fatty acid is found in fish fat and helps reduce triglycerides, lower blood pressure, and reduce the buildup of plaque in the arteries. It even reduces the risk of arrhythmia.
- Vitamin C. One of the most popular antioxidants, ascorbic acid, better known as vitamin C, is plentiful in many fruits and vegetables and enhances the body’s ability to fight free radicals. One of those free radicals it fights is glutathione, which contributes to the risk of coronary artery disease and heart attacks. Its oxidation effect also reduces LDL cholesterol. If that weren’t enough, it also strengthens blood vessel walls and improves the vessels’ ability to dilate, reducing blood pressure and improving blood flow.
- Magnesium. The mineral magnesium plays a crucial role in the function of your heart. Whereas the mineral calcium helps stimulate the contraction of the muscle, magnesium helps relax it by counteracting the calcium. Low magnesium is correlated with a higher risk of heart disease.
- Fiber. Psyllium fiber is crucial to help regulate cholesterol levels, among other bodily functions. The best way to get it is from eating food high in fiber—vegetables, tubers, legumes, and fruits—but if your diet has been light on fiber, a supplement may help.
- L-Carnitine. This amino acid may help improve the heart’s ability to absorb oxygen, as well as mitochondria all over the body to transport fats into the cells to be used as energy.
- Green Tea. Green tea, whether drank or taken as a supplement, has a demonstrated ability to lower total cholesterol and especially LDL cholesterol, two key risk factors in developing heart disease.
- Garlic. Garlic is a proven remedy for coronary artery disease and high blood pressure. It can be taken in pill form if you don’t want your breath to smell.
You should be aware of your heart health, and any of these common signs of an unhealthy heart and underlying health conditions. The #1 killer in America, heart disease can make a dramatic entrance, or it can sneak up on you.
Although there are effective preventative measures to introduce to your lifestyle, keeping a close eye out for these symptoms and reporting them to your health care professional is a very sensible idea. A great way to conveniently do this is to stay in the know using heart health biomarkers which you can regularly review with an simple blood test.