The image is a familiar one—a man hunched over, clutching his chest in pain. It’s the universal symbol for a heart attack. This chest pain, along with shortness of breath and pain radiating down the arm, are often considered the standard symptoms of a major cardiac event.
But there are more subtle symptoms of heart disease—a condition that includes heart attack, stroke and congestive heart failure.
Here’s everything you need to know about the six lesser-known signs and symptoms.
While obstructive sleep apnea, which almost always causes loud snoring, is not a symptom of heart disease, it isn’t just a noisy habit that can keep your partner up at night either, says cardiologist Suman Kuppahally, MD, of Good Samaritan Hospital in San Jose, California. Whether it’s moderate or severe, it may damage your heart as you struggle to breathe while sleeping.
“Sleep apnea causes a drop in oxygen in the blood several times during the night and that causes stress to the body,” Dr. Kuppahally says. “If left untreated, it can lead to cardiovascular problems such as high blood pressure, arrhythmias, heart attack and heart failure.”
If you snore, Kuppahally suggests consulting a sleep specialist right away to begin treatment.
Dizziness or lightheadedness may indicate that your brain isn’t getting enough blood, says Kuppahally, especially in women, who often have atypical symptomsof heart problems. Dizziness could indicate an arrhythmia (abnormal heartbeat), heart damage or heart valve problem like aortic stenosis.
If you’re experiencing dizziness along with other heart symptoms, get to the emergency room as quickly as possible.
A good workout isn’t the only thing that can cause you to break a sweat. If you start sweating suddenly—what’s often described as a “cold sweat”—while experiencing other symptoms, it could mean you’re having a heart attack.
“Sweating more than usual, without exertion, is a sign of stress to the body,” says Kuppahally. “If sweating is associated with discomfort in the chest, arm, neck or jaw or with shortness of breath, it should be taken seriously as a sign of coronary artery disease,” and you should get to the hospital immediately..
3. Fatigue or exhaustion
Most of us can feel worn out after a long day of dealing with work, kids and a mile-long to-do list. However, extreme, unexplained fatigue—the kind that leaves you too beat to climb a short flight of stairs or carry your groceries—could also be a warning sign of something more serious, like a heart attack or heart disease, especially in women.
One study published in the journal Circulation found that more than 70 percent of women experience unusual fatigue in the month leading up to their heart attacks. Some women ignored it as a symptom of a serious heart problem. And women who tried repeatedly to seek medical care often had this symptom misdiagnosed or dismissed by their physicians.
4. Erectile dysfunction
Heart disease and erectile dysfunction (ED)may both be caused by poor circulation, but problems in the bedroom usually occur first. This means that ED could be alerting you to current or future heart disease.
“ED and heart attack are both caused by plaque build-up in the arteries,” says Kuppahally. “Also, there’s a high prevalence of cardiovascular disease in patients with ED. And patients with heart failure or coronary artery disease frequently have other medical problems, such as diabetes and hypertension, which can cause ED.”
5. Tooth loss
Tooth loss can be a sign of poor oral hygiene, but it may also signal a heart problem. A 2018 study presented at an American Heart Association meeting suggests middle-aged adults (ages 45 to 69) who experience tooth loss might have a higher risk for coronary heart disease.
Participants who lost two or more teeth during the eight-year follow-up were at 16 percent greater risk of developing heart disease than those with no tooth loss. The connection between heart disease and tooth loss is not entirely clear, but research suggests inflammation may play a role in both. Tooth loss may not be cause for immediate concern, but it’s a good opportunity to speak with a healthcare provider about ways to reduce your heart disease risk.
Other unusual signs and symptoms
Kuppahally also advises her patients to be on the lookout for a few other unfamiliar symptoms of heart disease:
- Heart failure: leg swelling when upright, mild cough and shortness of breath while lying down
- High blood pressure: undiagnosed sleep apnea and early morning headaches
- Heart disease: depression and anxiety
To keep your heart in tip-top shape, stick with a healthy diet, get daily exercise, keep stress levels low and get adequate sleep.
Sourcing: UpToDate, American Heart Association, Mayo Clinic, Harvard Medical School, Heart Rhythm Society