How to Identify Symptoms of Various Heart Conditions

Symptoms of a Heart Attack

Symptoms of a heart attack can include:

• Discomfort, pressure, heaviness, or pain in the chest, arm, or below the breastbone
• Discomfort radiating to the back, jaw, throat, or arm
• Fullness, indigestion, or a choking feeling (may feel like heartburn)
• Sweating, nausea, vomiting, or dizziness
• Extreme weakness, anxiety, or shortness of breath
• Rapid or irregular heartbeats

Symptoms of Arrhythmias

Arrhythmias are problems with your heartbeat's rate or rhythm. They're also known as irregular heartbeats. There are different types of arrhythmias. Some don't cause any visible symptoms. Others may bring on symptoms such as:

• Palpitations (a feeling of skipped heartbeats, fluttering, or "flip-flops" in your chest)
• Pounding in your chest
• Dizziness or feeling lightheaded
• Fainting
• Shortness of breath
• Chest discomfort
• Weakness or fatigue (feeling very tired)

Some people who have arrhythmias don't need treatment. Others do. It depends on the type of arrhythmia you have and how severe it is. If your doctor says you need treatment, they may recommend one or more of the following options.

Some arrhythmia medicines are:

• Drugs to lower your heart rate, such as beta-blockers or calcium channel blockers
• Drugs to help your heart's rhythm, such as sodium channel blockers or potassium channel blockers
• Drugs called blood thinners (anticoagulants) to prevent blood clots

Some devices that can treat arrhythmias are:

• Pacemaker: A small device placed in your chest that helps keep your heart from beating too slowly.
• Implantable cardioverter-defibrillator: A device placed under the skin that can detect irregular heartbeats and give off shocks that reset your heart's rhythm.

Some procedures and heart surgeries that can treat arrhythmias are:

• Cardioversion, a treatment that involves sending a strong electrical shock to your heart to restore its usual rhythm
• Catheter ablation, a procedure that often uses heat or cold energy to make scars in the heart, which block the irregular electrical signals that cause some arrhythmias
• Maze procedure, in which a surgeon makes tiny cuts in the upper part of the heart to create scar tissue to block irregular signals that cause certain kinds of fast heartbeats
• Open-heart surgery to bypass blocked heart arteries if you have both arrhythmia and severe coronary artery disease

Symptoms of Atrial Fibrillation

Atrial fibrillation (AFib) is a type of arrhythmia. Most people with AFib have one or more of the following symptoms:

• Heart palpitations (a sudden pounding, fluttering, or racing feeling in the heart)
• Lack of energy
• Dizziness (feeling faint or lightheaded)
• Chest discomfort (pain, pressure, or discomfort in the chest)
• Shortness of breath (difficulty breathing during normal activities)

Some people with AFib have no symptoms. Bouts of AFib may be brief.

If you have AFib, various treatments can help control your heartbeat. AFib can also raise your risk of blood clots, and treatment can help prevent those, too.

Medicines for AFib can include:

• Drugs to lower your heart rate, such as beta-blockers or calcium channel blockers
• A drug called dioxin that may control your heart rate while you're at rest
• Drugs to help your heart's rhythm, such as sodium channel blockers or potassium channel blockers
• Drugs called blood thinners (anticoagulants), which are used to prevent blood clots

Some procedures that can help treat AFib are:

• Cardioversion, a treatment that involves the use of a device called a defibrillator or a medication to restore your heart's usual rhythm
• Catheter ablation, a procedure that often uses heat or cold energy to make scars in the heart, which block the irregular electrical signals causing arrhythmias
• Maze procedure, in which a surgeon makes tiny cuts in the upper part of the heart to create scar tissue that can block irregular signals that cause certain kinds of fast heartbeats
• Left atrial appendage closure, a procedure to lower the risk of blood clots in some people who can't take blood thinners

Symptoms of Heart Valve Disease

With heart valve disease, one or more of the four valves in your heart don't work as they should. These valves keep blood flowing in the proper direction through your heart. Symptoms of heart valve disease may include:

• Shortness of breath and/or trouble catching your breath (most noticeable while doing normal daily activities or when lying flat in bed)
• Weakness or dizziness
• Discomfort in your chest (you may feel a pressure or weight in your chest with activity or when going out in cold air)
• Palpitations (which may feel like a rapid heart rhythm, irregular heartbeat, skipped beats, or a flip-flop feeling in your chest)

If valve disease causes heart failure, symptoms may include:

• Swelling of your ankles or feet; swelling may also occur in your abdomen, which may cause you to feel bloated
• Quick weight gain, such as gaining 2-3 pounds in one day

Symptoms of heart valve disease do not always relate to how serious your condition is. You may have severe valve disease without any visible symptoms, requiring prompt treatment. Or, as with a type of heart valve disease called mitral valve prolapse, you may have severe symptoms, yet tests may show minor valve disease.

Symptoms of Heart Failure

With heart failure, your heart doesn't do a proper job of pumping blood to the rest of your body. Symptoms of heart failure can include:

• Shortness of breath, typically during activity, but it can also happen at rest, especially when you lie down flat in bed
• A cough that brings up white mucus
• Rapid weight gain (such as a weight gain of 2-3 pounds in one day)
• Swelling in ankles, legs, and abdomen
• Dizziness
• Fatigue and weakness
• Rapid or irregular heartbeats
• Other symptoms include nausea, palpitations, and chest pain

Like valve disease, heart failure symptoms may not be related to how weak your heart is. You may have many symptoms, but your heart function may be only mildly weakened. Or you may have a severely damaged heart, with few or no symptoms.

If you find out that you have heart failure, the treatment that's right for you usually depends on the cause of your condition. But treatment often includes drugs to control symptoms, such as:

• Diuretics or water pills to flush the body of fluids
• Beta-blockers to slow your heart rate and lower your blood pressure
• ACE inhibitors or angiotensin II receptor blockers (ARBs) to widen your blood vessels and lower your blood pressure
• Angiotensin receptor/neprilysin inhibitors (ARNIs), if needed, to take the place of ACE inhibitors or ARBs
• Potassium-sparing diuretics to boost heart function in some people with very severe heart failure
• Sodium-glucose cotransporter-2 (SGLT2) inhibitors to lower blood sugar and possibly help lower blood pressure
• Hydralazine and isosorbide dinitrate (BiDil) to help widen blood vessels if other treatments, like ACE inhibitors, don't work well enough

Some people with heart failure also need devices such as pacemakers and defibrillators. Sometimes, a device is placed in the body to help the heart work better and to prevent deadly arrhythmias. Another option is a ventricular assist device (VAD) — a pump that's placed in your chest to help one or both of your heart's lower chambers pump blood.

Some people with heart failure benefit from surgeries such as:

• Open-heart surgery to bypass blocked heart arteries if the blockages are causing heart failure
• Heart valve repair or replacement if heart failure is due to a damaged heart valve
• A heart transplant if heart failure is so serious that other surgeries or medicines don't help

Symptoms of Congenital Heart Defects

A congenital heart defect is a problem with how your heart forms while you're in the womb. So, you're born with it. Congenital heart defects may be diagnosed before birth, right after birth, during childhood, or not until adulthood. It is possible to have a defect and no symptoms at all. Sometimes, it can be diagnosed because of a heart murmur on a physical exam or an irregular imaging test, such as an EKG or chest X-ray, in someone with no symptoms.

Symptoms of a congenital heart defect may include:

• Shortness of breath
• Limited ability to exercise
• Symptoms of heart failure or valve disease
• Arrhythmias
• Palpitations (irregular heartbeats, or a "flip-flop" feeling in your chest)
• Dizziness
• Swelling called edema in the ankles, feet, or hands
• Bluish color in your fingernails, lips, or skin, also called cyanosis

If you're an adult with a congenital heart defect, treatment may include medicines, devices, or surgery.

Medicines may be an option if your defect is mild. These drugs can include:

• Drugs to lower your heart rate, such as beta-blockers or calcium channel blockers
• ACE inhibitors or ARBs to widen blood vessels and lower blood pressure
• Drugs called blood thinners (anticoagulants) to prevent blood clots
• Diuretics or water pills to flush the body of fluids

Congenital Heart Defects in Infants and Children

Symptoms of congenital heart defects in infants and children may include:

• Cyanosis (a bluish or gray tint to the skin, fingernails, and lips)
• Fast breathing and poor feeding
• Poor weight gain
• Lung infections that keep coming back
• Inability to exercise
• Swelling in the legs, stomach area, or around the eyes in the first few months of life
• Swelling in the hands, ankles, or feet later in childhood

It can be scary to learn that your child has a congenital heart defect, but many treatments help children live well and thrive. Some minor conditions can clear up on their own or can be treated easily with medications. Some of the same medicines that help treat congenital heart defects in an adult may be options for a child, such as water pills, blood pressure drugs, and drugs that control irregular heartbeats.

Those defects that are more complex can often be treated surgically, if needed. Some surgeries done on adults may also be options for some children, including cardiac catheterization, heart surgery, and heart transplants. Rarely, surgery to fix certain severe heart defects is done while the baby is still in the womb during pregnancy.

After treatment, your child's cardiologist will likely suggest ongoing checkups to make sure your child's heart is doing well.

Very rarely, the heart problem is so severe that it cannot be corrected.

Symptoms of Heart Muscle Disease

Many people with heart muscle disease, or cardiomyopathy, have no symptoms or only minor symptoms, and live a normal life. Other people develop symptoms, which worsen as heart function worsens.

Symptoms of cardiomyopathy may occur at any age and may include:

• Chest pain or pressure (usually occurs with exercise or physical activity but can also occur with rest or after meals)
• Heart failure symptoms (see above)
• Swelling of the lower extremities
• Fatigue
• Fainting
• Palpitations (fluttering in the chest due to abnormal heart rhythms)

Some people also have arrhythmias. These can lead to sudden death in a small number of people with cardiomyopathy.

If you have cardiomyopathy, treatment can ease symptoms and slow the disease from getting worse. Treatment for cardiomyopathy will depend on the cause but often includes the same measures used for people with heart failure. The outcome also depends on the underlying cause. For some people, heart transplant surgery may be recommended.

Symptoms of Pericarditis

Pericarditis is inflammation and irritation of the thin, fluid-filled sac that surrounds your heart. When present, symptoms of pericarditis may include:

• Chest pain which is different from angina (chest pain caused by coronary artery disease); it may be sharp and located in the center of the chest. The pain may radiate to the neck, arms, and back. It may worsen when lying down, taking a deep breath, coughing, or swallowing, and may improve when you sit up and lean forward.
• Low-grade fever
• Increased heart rate
• Dry cough
• Swollen legs or feet
• Fatigue

Pericarditis often eases on its own, but treatment may include:

• Anti-inflammatory drugs, such as aspirin
• Medicines that lower inflammation, such as colchicine, or certain drugs that work on the immune system
• Steroids (in severe cases)
• Fluid drainage: Sometimes, fluid must be drained from the pericardium using a long, thin needle inserted carefully through the chest. If a chronic condition develops, a small opening in the pericardium may need to be created surgically to let this fluid drain.
• Surgery: Rarely, it may be needed to make a pathway for the extra fluid to drain internally or remove part or all of the pericardial sac.

Questions for Your Doctor

If you’ve been diagnosed with heart disease, ask your doctor these questions at your next visit.

• What caused my heart problem?
• How severe is my heart problem?
• What treatments do I need, and are there side effects?
• Should I start a cardiac rehab program to make my heart stronger?
• What should I do if my symptoms get worse quickly?
• What can I do to prevent this from getting worse or having a heart problem again?
• Should I eat different foods?
• How will this affect my activities, such as having sex, working, or caring for my children or grandchildren?
• What can I do to feel less stress and worried?
• How often do I need to come in for an office visit?

Staying on Track

With heart disease, it may feel like you're going through a lot of changes all at once. It's a good idea to get help from dietitians, doctors, and support groups to keep focused.

Some of the keys to making changes are:

• Have a plan before starting.
• Set realistic targets.
• Make one change at a time. For example, if you smoke, quit before you overhaul your diet.
• Write down your goal.
• Prepare for setbacks. They happen. What matters more is that you get back on track.
• Reward yourself for your progress. Pick a treat that feels great but won't undo your hard work.
• Keep up with your friends and family. Your social connections are good for you.
• Also, stay in touch with your mood. For many folks, depression comes along with heart disease. If you notice that's true for you, talk to your doctor to get treatment.

When to Call Your Doctor

Call your doctor if:

• You have unusual chest pain, especially if it doesn't go away or if it comes back. It could be heartburn, but it could also be a sign of angina or a heart attack.
• You have pain or discomfort in your neck, jaw, back, arm, or shoulders. This can also be a warning sign of a heart attack.
• You have irregular heartbeats that keep coming back. If frequent or persistent, uneven heartbeats may signal a serious heart condition.
• You become suddenly dizzy, lightheaded, weak, or faint. Even if the cause is not heart disease, it could be serious.
• You have shortness of breath at rest or with little physical activity.
• You experience a sudden loss of consciousness.
• You have trouble moving or feeling parts of your body.

"If a patient is worried about a heart-related event, then they should seek medical care as soon as possible," Shah says. "It is better to be safe than sorry."

Takeaways

Heart disease is the name for a broad group of conditions that affect the heart. See your doctor as soon as possible if you think you might have heart-related symptoms. For some types of heart disease, timely diagnosis and treatment can be lifesaving.

Heart Disease Symptoms FAQs

Is coughing a symptom of heart disease?

Coughing can be an atypical symptom of heart disease, Shah says. Atypical symptoms often happen in women, elderly people, and people with diabetes. It's important to get an atypical symptom, such as coughing, checked to find out if it's heart-related or not.

Is belching a symptom of heart disease?

Belching can also be an atypical symptom of heart disease, Shah says.

What are the symptoms of heart disease in women?

Women are more likely than men to have heart attack symptoms such as pain in the jaw, neck, shoulder, upper back, or upper stomach. Women are also more likely to have shortness of breath, pain in one or both arms, upset stomach or vomiting, sweating, dizziness, extreme tiredness, and heartburn. It may also be more common for women to have heart attack symptoms while at rest.

Women with heart failure are more likely than men to get symptoms such as trouble exercising, swelling called edema, and shortness of breath during physical activity.

Studies have shown that women have more missed heart-related events than men, Shah says. So if you're a woman, get any troubling symptoms checked ASAP. "Listening to your body and sharing concerns with health care providers during routine visits is also very important," Shah says.

How do you know if you have heart disease symptoms?

The only way to find out for sure is to see your doctor as soon as possible and get your symptoms checked. "It is important to at least be evaluated and have shared decision making with [health care] providers so that everyone can be on the same page when it comes to doing further testing and understanding why it is important to do them if necessary," Shah says.