The signs and symptoms of heart disease vary drastically. Some are more commonly known, such as pain or discomfort in the chest. Other signs are more surprising—heart disease can manifest via skin conditions, for example—and some people who suffer from heart disease may have no symptoms at all.
A new report released by the American Heart Association (AHA) provides an updated look at the most reported symptoms of six types of cardiovascular disease (CVD): heart attack, heart failure, valve disease, stroke, heart rhythm disorders, and peripheral artery and vein disease (PAD and PVD). Critically, the report emphasizes that any and all symptoms must be taken into account when evaluating a patient's risk of heart disease.
"The most important takeaway [of the new report] is that symptoms are subjective and can vary based on age, gender, and other health conditions," says Kaustubh Dabhadkar, MD, a cardiologist in Charlotte, North Carolina. Read on to find out more.
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The most common sign of heart disease can be mistaken for other conditions.
The new report stresses that doctors need to know about all of patient's symptoms when evaluating their heart health, even if they don't immediately seem to be linked.
The AHA maintains that the most common symptom of heart disease is chest pain. Caused by a disruption to the flow of blood to the heart, and also known as angina or angina pectoris, it is often described as "squeezing, pressure, heaviness, tightness or pain in the chest," advises the Mayo Clinic, as well as a feeling of heaviness on the chest. "Angina may be a new pain that needs to be checked by a health care provider, or recurring pain that goes away with treatment."
The Mayo Clinic warns that angina may manifest similarly to other kinds of chest pain "such as the discomfort of indigestion." "If you have unexplained chest pain, seek medical help right away," says the site. The AHA report stresses that considering other other potential symptoms of heart disease is one way to determine whether your chest pain is angina.
Men and women may have different symptoms of heart disease.
When experiencing a heart attack, women may be more likely to have nausea and pain in the shoulders and upper back along with chest pain, says MedicineNet. The AHA report points out that it's important to note how other types of heart disease may differ with regards to gender.
According to the AHA's report, women may have no symptoms of peripheral artery disease (PAD), whereas men may experience leg pain. When women do have symptoms, it "may be wrongly attributed to other conditions such as osteoarthritis, or even dismissed under the false assumption that peripheral artery disease is more common among men," warns MedicineNet. This may explain why women can frequently be diagnosed with illnesses "later than they would have been diagnosed if they were men," Christopher Lee, vice chair of the AHA report's writing committee, told the site.
Depression may affect a person's ability to recognize symptoms of heart disease.
Studies have found a significant, complex connection between depression and heart disease. "People with depression are more likely to develop heart disease, [and] people with heart disease can experience depression," the AHA reports. "Research suggests 15 percent to 30 percent of people with cardiovascular disease have depression—a rate two to three times higher than the general population." Roy Charles Ziegelstein, M.D., wrote in an article published by Johns Hopkins Medicine that "people with depression but no previously detected heart disease, seem to develop heart disease at a higher rate than the general population."
This connection, and the similarities shared by two conditions, can also lead to confusion when it's time for a diagnosis. "In young adults, palpitations are often confused with anxiety," notes Dabhadkar. "I often see patients who have been treated for generalized anxiety disorder for years but have a heart rhythm disorder."
In addition, people suffering from depression may not be able to readily identify symptoms of a heart condition. "Depression, common across many CVDs, may influence a person's ability to detect changes in symptoms," warns the AHA's new report.
Patients need to go in-depth with their doctors about symptoms.
The report explains that other warning signs of heart disease can include "shortness of breath, fatigue, sweating, nausea, and lightheadedness"—but the AHA emphasizes the importance of exploring all the symptoms a patient is experiencing, regardless of their gender or whether these symptoms seem heart-related or not.
"Symptoms may go unrecognized or unreported if people don't think they are important or related to an existing health condition," the AHA wrote on SciTechDaily. "In addition, symptoms may occur without changes in disease progression, and disease state may also progress without symptoms."
"Often, an experienced clinician has to dig out symptoms," says Dabhadkar. "We often see patients who have lived with symptoms of heart disease or heart failure for long enough that it has become their new normal." He adds that patients need to be allowed to describe their symptoms "in their own words."