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    Early Symptoms of Heart Disease

    Dominic C. Cefali, MD, PhD, FACS Cardiothoracic Surgeon, The Heart Group Cardiothoracic Surgeon, The Heart Group 06/03/2021

    In my nearly 20 years of practice, I've had thousands of patients tell me that they can look back and recognize symptoms they were having prior to their heart attack--certain "warning signs" in the days/weeks/months leading up to the heart attack.

    Heart attacks are serious—they’re a true emergency:

    • Half of people who die from heart attacks pass away within the first hour of having symptoms.
    • Every second matters to save heart muscle—and to save your life. Call 911!
    • Many patients experience symptoms but they wait too long.

    It’s important to learn symptoms of a heart attack, as well as the warning signs that can lead up to a heart attack. I’ll also discuss what to do if you experience them.

    Defining Heart Disease
    To start, I want to give a short background on what heart disease is, and the symptoms of heart attacks themselves.

    Heart disease is a broad term that may include many different conditions. The heart can suffer an injury through blockages of the arteries that provide oxygen and nutrients to the heart muscle. This injury can lead to a heart attack. The electrical, or conduction, system of the heart can have problems leading to arrhythmias (where the heart beats abnormally or “skips a beat”) such as atrial fibrillation. There can also be structural problems in the heart that can require repair, such as the valves of the heart not working well.

    Heart Disease Risk Factors
    Many heart conditions can be avoided, or at least delayed, through managing risk factors. These risk factors include:

    • Smoking
    • High blood pressure
    • Diabetes
    • High cholesterol and triglyceride levels
    • Lack of physical activity
    • Overweight and obesity
    • Family history of heart attack before the age of 50.

    Signs & Symptoms of a Heart Attack
    Signs and symptoms of a heart attack are varied from person to person. These can include:

    • Discomfort—tightness, squeezing, aching in the chest, arms, neck, jaw or in the back between the shoulder blades
    • Shortness of breath
    • Nausea
    • Feeling clammy or sweaty
    • Fatigue
    • Sense that something is terribly wrong

    If you or someone else is having these symptoms, call 911. Try to keep calm. If you are with someone, be prepared to perform CPR.

    Special Concerns for Women
    Women need to know about heart disease signs and symptoms because it’s the number one killer of women. Far more women die of heart disease than of all cancers combined.

    It’s important to know some unique risk factors women have for heart disease, including menopause, numerous ovarian cysts, or high blood pressure or diabetes that they experienced during pregnancy.

    Also, women’s heart attack symptoms may vary a bit from a man’s. Many women don’t experience the crushing chest pain that people think of. They may not have pain, or may only experience it in the neck, jaw or back. Shortness of breath is a major sign, as are nausea/vomiting, dizziness or lightheadedness and a cold sweat.

    Warning Signs of Heart Disease, What To Do
    There are symptoms of heart disease that are warnings that something bigger may be coming—almost like “pre-heart-attack” symptoms.

    People who have had heart attacks and survived them report experiencing many—if not most—of these symptoms in the days, weeks and even months leading up to their heart attacks:

    • Unusual tiredness, fatigue that stays with you.
    • Trouble sleeping
    • Shortness of breath
    • Dizziness or lightheadedness, especially with exertion like going up stairs
    • Occasional passing chest pain or tightness
    • Swelling in legs or ankles; overall fluid retention

    If you are experiencing some of the warning signs of heart disease, make an appointment to talk with your PCP right away. He or she will likely recommend some combination of the following tests:

    • Blood work for checking electrolytes, kidney function, and/or cardiac enzymes.
    • EKG
    • Stress test and/or echocardiogram
    • Possibly lung function studies
    • Don't be embarrassed to be checked out, and don't ignore the symptoms. Doctors will tell you that they wish so many of their patients would've mentioned symptoms sooner prior to having a major cardiac event.

    For more information about heart health and treatment for heart problems, visit




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