If the importance of heart health isn’t already perfectly clear, let this one statistic do the heavy lifting for you — at 600,000 (or more) fatalities per year, heart disease is the #1 cause of death in the United States (besides COVID-19 in any age groups). 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.
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, being wheeled into the operating room.
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 dramatic scenes from becoming a reality.
Most often, there are little to no symptoms with heart disease. That’s why screening programs are so important.
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. This pain 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. Remember, hundreds of thousands of “silent “ heart attacks occur every year in the US alone. Many symptoms can be deceptively mild.
3. Left shoulder pain
Interestingly, the nerves in the left arm and the nerves in the heart can 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 a ‘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 sign of an unhealthy heart.
Seek medical attention immediately if you 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 there are many arrhythmias that are potentially dangerous so all arrhythmia symptoms, however mild, should be taken seriously.
Some forms of arrhythmia may be easily noticeable. There are many kinds of arrhythmias to be aware of; here are some, but certainly not all, to look out for:
- 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. This high risk can be greatly reduced with the proper drugs, but not unless the atrial fibrillation has been diagnosed. Most atrial fibrillation has little or no symptoms, so screening is critical. Look out for atrial flutter as well. It’s 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 inside your heart become garbled, the lower chambers of the heart beat too rapidly. Your heart’s ventricles squeeze irregularly and ineffectively. This is highly dangerous and requires immediate assistance.
5. Heartburn, stomach pain or back pain
People – women especially – need to be especially careful of persistent heartburn, stomach or back pain. Many factors cause these conditions, but for reasons not fully understood, women have a much higher propensity to manifest heart trouble as heartburn, stomach pain or back 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.
Both men and 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 inefficiently, gravity starts to pool the blood closer to your lower extremities throughout the day.
If your shoes, socks, 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.
7. Lack of stamina
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, specifically if they have an underlying heart condition.
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, people, and 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 signs 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 and blood pressure issues, 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 a damaging sleep condition, leading itself to prediabetes and possible heart disease.
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 regularly.
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.
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 home 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. This inflammation from 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. Too many of these fatty particles in your blood may be a sign of thickening of arterial walls or obstructed blood flow, and cardiovascular inflammation associated with soft plaque.
- LDL-C. LDL-C – which most still refer to as the “bad” cholesterol – can build up in arteries and cause cardiovascular inflammation.
- 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.
- HbA1c. Excess levels of hemoglobin AC-1 may be an indicator of several heart conditions and is a common screening tool for prediabetes – one of the most common root causes of soft plaque and cardiovascular inflammation, and therefore heart attacks and death.
If any of these indicators fall outside of ‘normal’ ranges, further testing may be recommended by your specialist.
While waiting for your test results, follow-up appointment, or if you just want to make some lifestyle adjustments to reduce your risk for heart disease, here are several things you can do to boost your heart health.
The most important parts of keeping a healthy heart is to maintain a healthy weight and to stay active. Many of the risks are reversible with a healthy life. While aging is the most important factor of heart health – unfortunately it cannot be changed.
1. Control your cholesterol, blood pressure, and prediabetes
High blood pressure and bad cholesterol levels (high LDL, low HDL) can be major risk factors of heart disease.
Hypertension, or high blood pressure, can cause damage by putting excess strain on the heart and lead to atherosclerosis. High blood pressure may be controlled through diet and exercise. A doctor may prescribe certain medications to get it under control. Sadly, more than half of American adults have high blood pressure and may not even know it.
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.
Prediabetes is very important to control – and it’s more common than you think. According to the CDC, 1 in 3 American adults have prediabetes. And 90% of those who have it don’t know they have prediabetes. Prediabetes (also called metabolic syndrome) can cause high blood sugar, high blood pressure, low LDL, high triglycerides, and excess belly fat around the waist.
According to Dr. Ford Brewer, MD, MPH, there is a lot of evidence showing that this condition can cause a heart attack, stroke, eye damage, and several other diseases. It is a major cause of plaque and cardiovascular inflammation, which means that it can increase your risk of heart attack and stroke.
2. Exercise regularly
A sedentary lifestyle (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 like walking can dramatically improve your heart health, as well as lower 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.
Dr. Brewer, along with other heart-health physicians, recommend high intensity interval training (HIIT) and muscle-mass building exercises for optimum heart health.
3. 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.
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.
4. Stop smoking & reduce alcohol intake
Smoking damages the blood vessels leading to your heart, brain and other parts of your body. This makes you four times more likely to die of heart attack or stroke and three times more likely to die from sudden cardiac death than a non-smoker.
Some studies show that moderate alcohol intake actually benefits heart health, but it’s difficult to see clearly cause and effect from those studies. Excessive alcohol consumption on the other hand is hard on the heart, and, as well, exacerbates risk factors like excess body weight due to loss of impulse control when intoxicated. When mixed with certain other drugs, especially stimulants, alcohol can lead to heart issues. In some extreme cases, alcohol intake puts a person at risk for substance abuse concerns.
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.
5. Consider heart health supplements
Certain vitamins, minerals, and other substances are known to contribute to heart health. You can support your healthy lifestyle by considering supplementing your diet with concentrated formulations of these substances. Remember, you can’t “out supplement” a lifestyle problem – but supplements can help:
- Vitamin D3 Vitamin D – Might help heart health, although recent research showed that supplementation does not appear to reduce the risk of a cardiovascular event. Vitamin D has many other benefits to systems that can indirectly help heart health – like immune and bone health. A level of 60-80 ng/mL (taken through a vitamin D test) is considered adequate.
- Niacin – Can be a heart health helper for certain cardiovascular issues, like increased Lp(a). Lp(a) is linked with increased cardiovascular risk. The goal, however, is not to eradicate Lp(a) totally, as most people with genetic traits of high Lp(a) can’t reverse it. We do see a significant improvement in inflammation if Lp(a) is decreased by 25 to 30%, something that can be seen from taking niacin. Those with Lp(a) should work with a cardiologist or lipidologist on management of treatment.
- Vitamin K2 – Affects the activity of certain enzymes involved in calcium distribution, but K2 also has effects against insulin resistance.
- 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 which might contribute to the risk of coronary artery disease and heart attacks.
- Magnesium – The mineral magnesium plays an important 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 can be important 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.
Heart disease is branded a ‘silent killer’ for a reason
Many people with good weight, low cholesterol and high physical activity still have heart attacks and strokes. There is more to heart health than previously imagined. So even people with minor “risk” factors still have heart attacks. Continual monitoring of our heart health is always encouraged by doctors.
So make sure that any changes start with lifestyle practices – changing your health (and your heart) for the better.
You should be aware of your heart health, and any of these common signs of an unhealthy heart and underlying health conditions. 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 a simple blood test.