The Key Symptoms of Heart Disease

Chest Pain, Dizziness, Shortness of Breath and More

Tired woman sitting on edge of bed
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While there are many different types of heart disease, and while each can produce its own set of symptoms, there are some key symptoms that are common to many kinds of cardiac disease. If you experience any of these symptoms, you should see your doctor to have them evaluated.

Chest Pain or Chest Discomfort

Few symptoms are more alarming than chest pain. In the minds of many people, chest pain equals heart pain.

And while many other conditions can cause chest pain, cardiac disease is so common — and so dangerous — that the symptom of chest pain should never be dismissed out of hand as being insignificant.

"Chest pain" is an imprecise term. It is often used to describe any pain, pressure, squeezing, choking, numbness or any other discomfort in the chest, neck, or upper abdomen, and is often associated with pain in the jaw, head, or arms.

Depending on its cause, chest pain may last from less than a second to days or weeks, might occur frequently or rarely, and might occur completely randomly or under predictable circumstances. Sorting through these variations can help your doctor determine the actual cause of your chest discomfort, in particular, whether it represents anginaor some other serious problem — which is why you should get help from a medical professional if you have chest pain. You should also have some idea as to when you should consider chest pain to be an emergency.

 

Palpitations

Palpitations, an unusual awareness of the heartbeat, is an extremely common symptom. Most people who complain of palpitations describe them either as "skips" in the heartbeat (that is, a pause, often followed by a particularly strong beat), or as periods of rapid and/or irregular heartbeats.

Most people with palpitations have some type of cardiac arrhythmia— an abnormal heart rhythm. There are many types of arrhythmias, and almost all can cause palpitations. The most common causes of palpitations are premature atrial complexes (PACs)premature ventricular complexes (PVCs), episodes of atrial fibrillation, and episodes of supraventricular tachycardia (SVT).

Unfortunately, on occasion, palpitations can signal a more dangerous heart arrhythmia, such as ventricular tachycardia. Palpitations are more likely to signal a serious cause if they are accompanied by episodes of lightheadedness or dizziness.

If you experience palpitations, you should discuss this symptom with your doctor. He or she may want you to have ambulatory monitoring for a short period of time to evaluate what, specifically, is causing your symptoms.

Lightheadedness or Dizziness

Episodes of lightheadedness or dizziness can have many causes, including anemia (low blood count) and other blood disorders, dehydration, viral illnesses, prolonged bed rest, diabetes, thyroid disease, gastrointestinal disturbances, liver disease, kidney disease, vascular disease, neurological disorders, dysautonomiasvasovagal episodesheart failure and cardiac arrhythmias.

Because so many different conditions can produce these symptoms, anybody experiencing episodes of lightheadedness or dizziness ought to have a thorough and complete examination by a physician.

And since disorders of so many organ systems can cause these symptoms, a good general internist or family doctor may be the best place to start.

Syncope (Fainting/Loss of Consciousness)

Syncope is a sudden and temporary loss of consciousness, or fainting. It is a common symptom — most people pass out at least once in their lives — and often does not indicate a serious medical problem. However, sometimes syncope indicates a dangerous or even life-threatening condition, so when syncope occurs it is important to figure out the cause.

The causes of syncope can be grouped into four major categories: neurologic, metabolic, vasomotor and cardiac. Of these, only cardiac syncope carries a serious threat of causing sudden deathVasomotor syncope (commonly called vasovagal syncope) is by far the most common cause. Neurologic and metabolic syncope are relatively rare. 

Any loss of consciousness should be evaluated by a doctor. 

Fatigue, Lethargy or Daytime Sleepiness

Fatigue, lethargy or somnolence (daytime sleepiness) are very common symptoms. Fatigue or lethargy can be thought of as tiredness, exhaustion, or loss of enthusiasm that makes it difficult to function at your normal levels. Somnolence implies that you either crave sleep, or worse, that you find yourself suddenly asleep during the daytime — a condition known as narcolepsy.

While fatigue and lethargy can be symptoms of heart disease (particularly, of heart failure), these common and non-specific symptoms can also be due to disorders of virtually any other organ system in the body. People who suffer from fatigue or lethargy need a good general medical evaluation in order to begin pinning down a specific cause.

Somnolence is often caused by nocturnal sleep disorders such as sleep apnearestless leg syndrome or insomnia. All these sleep disturbances, however, are more common in patients with heart disease.

Dyspnea (Shortness of Breath)

Dyspnea, the medical term for shortness of breath, is most often a symptom of cardiac or pulmonary (lung) disorders. Heart failure and coronary artery disease frequently produce shortness of breath. Patients with heart failure commonly experience dyspnea with exertion, or orthopnea (dyspnea when lying flat). They also can suddenly wake up at night gasping for breath, a condition known as paroxysmal nocturnal dyspnea. Other cardiac conditions such as heart valve disease or pericardial disease can produce dyspnea, as can cardiac arrhythmias.

Numerous lung conditions can produce shortness of breath including asthma, emphysema, bronchitis, pneumonia, or pleural effusion (a fluid accumulation between the lung and chest wall).

Shortness of breath is almost always a sign of a significant medical problem, and should always be evaluated by a doctor.

A Word From Verywell

The symptoms most commonly caused by heart disease can also be produced by other medical conditions, from very serious to entirely benign. If you experience chest pain or discomfort, palpitations, lightheadedness, syncope, excessive fatigue or dyspnea, you need an evaluation to identify the cause. These are symptoms that should never be ignored.

Sources:

Fihn SD, Blankenship JC, Alexander KP, et al. 2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the Guideline for the Diagnosis and Management of Patients with Stable Ischemic Heart Disease: a Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2014; 64:1929.

Zimetbaum P, Josephson ME. Evaluation of Patients with Palpitations. N Engl J Med 1998; 338:1369.

Neuhauser HK, Radtke A, von Brevern M, et al. Burden of Dizziness and Vertigo in the Community. Arch Intern Med 2008; 168:2118.

Task Force for the Diagnosis and Management of Syncope, European Society of Cardiology (ESC), European Heart Rhythm Association (EHRA), et al. Guidelines for the Diagnosis and Management of Syncope (version 2009). Eur Heart J 2009; 30:2631.

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