The heart is a remarkable and lifesaving organ. Positioned at the centre of the circulatory circuit, it pumps blood around your entire body at every heartbeat, supplying oxygen and nutrients to every cell and carrying away waste products. As this muscle is vital for life and normal function, grasping its operation and recognizing early warnings of cardiac issues or cardiovascular disease is essential.
What is cardiovascular disease?
Cardiovascular disease, or CVD, encompasses various disorders that involve the heart and blood vessels1. The most common examples include stroke, coronary heart disease, peripheral vascular disease (PVD), congenital heart disease in children, and heart failure 2. In Australia, an astonishing 1.2 million adults live with one or more cardiac or vascular conditions, and CVD accounts for 27% of deaths in the country2. Being aware of how heart disease, PVD, and heart valve disorders manifest can play a key role in significantly lowering this disturbing figure2.
Signs and symptoms of CVD or heart disease
Any indication of cardiovascular disease or heart malfunction demands urgent attention, and you may experience multiple warning signs at once. If you notice any of the following, seek emergency medical care or call an ambulance. These warning signs of a heart problem (such as CVD or heart disease) often include:
Chest pain
Arguably the most prominent indication of cardiac distress is discomfort or pressure in the chest. A heart attack frequently feels like a heavy weight or unrelenting pressure, similar to a very tight strap surrounding your chest, often accompanied by a severe, constricting ache. Many people describe it as a crushing heaviness that can be alarming and persistent. If this pain only emerges during physical exertion (such as exercise), it may be less likely to signal a heart attack but still merits discussion with your GP3.
A choking sensation
Comparable to the chest-tightening feeling, this can also be sensed in your throat, leaving you with a frightening impression that you cannot breathe or are choking unexpectedly. Even if it arises at rest without any obvious trigger, it should not be ignored3.
Feeling nauseous or extreme fatigue
While nausea or tiredness on their own are common and often harmless, experiencing these symptoms along with chest discomfort while at rest, or feeling an overwhelming sense of exhaustion despite no change in your usual routine, could point towards a cardiac issue3.
Abdominal discomfort or indigestion
Because the heart, oesophagus, and stomach lie in close proximity, pain originating in the heart can mimic the burning sensation of indigestion. Doctors use diagnostic guidelines and tests to distinguish between the two, but each case requires individual assessment to uncover the true cause of the pain3.
Excessive sweating and clamminess
Perspiration is normal during heat or exercise, but breaking out in a cold, clammy sweat in conjunction with chest pain is alarming. Such a sudden onset of sweaty, moist skin alongside any chest discomfort should be taken seriously, as it may be a sign of heart problems3.
Pain in the arm, jaw, or back
Discomfort that radiates into one or both arms (especially the left), spreads up into your neck, or manifests as persistent pain in the jaw or upper back, can indicate underlying cardiac distress and warrants prompt medical evaluation3.
Swollen ankles
While ankle swelling can result from many causes, notably large or persistent swelling in one or both ankles, particularly if you are not taking medications known to cause fluid retention, may signal heart failure. Such ongoing swelling should be examined by a healthcare professional3.
Irregular heartbeat
Occasional palpitations are often harmless, but if your heart starts beating irregularly, racing, skipping, or feeling erratic, and this pattern deviates from what you normally experience, it is best to seek immediate medical assessment3.
Peripheral Arterial Disease
Although the earlier signs listed above often suggest potential heart issues, the appearance of severe pain or involuntary cramping in the legs during walking might specifically signal the presence of Peripheral Arterial Disease (PAD)3. PAD develops when circulation becomes inefficient because of a progressive buildup of fatty deposits (atherosclerotic plaques) along the inner lining of your arteries4. This disorder significantly increases your susceptibility to both coronary heart disease and cerebrovascular events such as stroke if left unmanaged. Individuals over the age of 60 are more frequently affected by PAD than any other demographic4. Additional risk factors include smoking, diabetes, obesity, and high blood pressure. When walking triggers intense leg pain and markedly impairs circulation, the likelihood of a heart attack rises three to five times above normal. To mitigate this risk, it is essential to embrace a healthier lifestyle, take any prescription medications recommended by your healthcare provider, and engage in structured walking rehabilitation programs, such as supervised treadmill sessions or tailored exercise regimens, to manage discomfort. Should these approaches fail to yield relief, physicians might advise surgical interventions or endorse more invasive procedures4.
Heart valve disease
Our heart valves are essential for normal cardiac operation, controlling the one-way movement of blood into, through, and out of the heart chambers5. Heart valve disease can evolve slowly over time or present suddenly, and its intensity may range from mild dysfunction to a critical, life-threatening condition. Patients may experience fatigue, shortness of breath, chest discomfort, or swelling in the ankles when valve performance deteriorates, underscoring the need for early detection and ongoing monitoring. There are several distinct types of valve disorders, which often coexist in the same patient5:
- Stenosis: Valve flaps become excessively thick, rigid, or narrowed, forcing the heart to work harder to push blood through, potentially leading to hypertrophy of the cardiac muscle.
- Regurgitation (or insufficiency): When valve flaps fail to seal completely, blood leaks backward, frequently producing a heart murmur and causing volume overload that impairs efficient blood circulation.
- Atresia: A rare congenital defect in which a valve fails to form properly, and fibrous tissue blocks the passage between chambers, requiring surgical correction early in life.
Recognising Heart Valve Disease
Recognising the warning signs of heart valve disease is crucial. Often, one of the earliest indicators is a heart murmur (an atypical sound of your heartbeat that your doctor perceives through a stethoscope). It’s important to remember that detecting a murmur does not necessarily mean there is a more serious heart condition present. If you notice any of the following symptoms, arrange for medical assessment without delay:
- Chest pain
- Dizziness or fainting
- Irregular heartbeat
- Palpitations
- Shortness of breath
- Swelling in the ankles or feet
- Persistent tiredness
A formal diagnosis may be made via a physical examination or with a chest X-ray. Treatment approaches include medication, valvuloplasty (using a balloon to dilate a narrowed heart valve), or surgical intervention. In the most severe cases, when blood flow throughout the body is significantly affected, a heart valve replacement5.
When to Seek Help for Heart Issues
Never postpone seeking professional advice when it comes to your heart. Should any of the aforementioned signs appear, promptly consult a doctor or cardiologist. The positive news is that many heart problems can be managed or substantially improved through healthy lifestyle changes, dietary adjustments, and the appropriate prescription medications. While hearing news about a heart condition can be frightening, adhering to expert guidance and adopting recommended habit changes often allows individuals to maintain a long and active life5.