Heart Disease Symptoms: How to Recognise a Heart Condition

Heart disease symptoms manifest through complaints like a feeling of pressure in the chest, shortness of breath, palpitations, and quick fatigue. The clearest answer to how a heart condition is recognised is correctly reading these early signals your body gives while under exertion or at rest. Early diagnosis plays a vital role in preventing a heart attack and leading a healthy life.

In Brief:

• Chest pain is the most common and distinct sign that the heart is not getting enough blood.
• Shortness of breath, especially when increasing with exertion, can be an early signal of heart failure.
• Heart attack symptoms in women can be more subtle (nausea, back pain) compared to men.
• Silent heart attacks can occur without experiencing distinct chest pain.
• Regular cardiological check-ups are critical for the early detection of hidden heart diseases.

Chest Pain (Angina)

Chest pain related to cardiovascular disease is medically called angina pectoris. It usually occurs during physical exertion such as climbing stairs or walking up a hill, during highly stressful moments, or after a heavy meal when the heart's workload increases. This pain is a squeezing, crushing, or burning sensation that starts right in the middle of the breastbone or on the left chest, and can radiate to the left arm, jaw, neck, and back. Many patients describe this condition as "a heavy weight sitting on my chest."

This pain, which can last for minutes, may ease or completely pass by resting or using sublingual pills or oral sprays previously prescribed by your doctor. However, severe chest pains that last longer than 15 minutes despite resting, accompanied by cold sweats and nausea, are direct heart attack symptoms. In such a situation, you must call for emergency medical help without wasting time.

Shortness of Breath (Dyspnoea)

Heart-related shortness of breath usually starts with physical activity and shows progressive characteristics over time. The feeling of breathlessness, initially felt only during brisk walks or climbing stairs, can appear while walking on a flat road or even while resting as the disease progresses. Fluid accumulation in the lungs as a result of the heart muscle not pumping blood adequately is the main cause of this shortness of breath.

In untreated heart failure cases over time, patients feel the need to increase the number of pillows they use at night. Difficulty lying flat, waking up at night with a feeling of suffocation, and coughing (orthopnoea) are quite typical symptoms. If you have recently been getting out of breath more quickly than before while doing your daily chores, seeing a cardiology specialist instead of attributing this to old age or a lack of fitness is the right step for your health.

Palpitations (Arrhythmia)

Many people feel their heart beating fast from time to time, but the answer to why heart palpitations occur is not always innocent. Palpitations are the sensation of abnormal, irregular, or uncomfortably fast heartbeats in the chest or neck area. While excessive tea or coffee consumption, stress, insomnia, or certain thyroid diseases can lead to palpitations, a direct malfunction in the heart's electrical system (arrhythmia) can also cause this condition.

Especially if palpitations that are much faster than normal (tachycardia), irregular, or start and stop suddenly are accompanied by dizziness, blackouts, sweating, or a feeling of fainting, this points to a serious heart disease. For this group of patients, an early ECG (electrocardiography) and a 24-hour rhythm Holter monitor are essential. If your doctor deems it necessary, an electrophysiological study and ablation procedure can also be successfully performed to find and treat the source of the rhythm disorder.

Oedema (Water Retention in the Body)

Oedema is the accumulation of fluid and swelling in various parts of the body due to heart failure. When the heart cannot pump blood to the body with sufficient pressure, blood pools in the vessels and fluid leaks into the tissue spaces. Especially with the effect of gravity, oedema is frequently seen on the front of the legs, ankles, and the top of the feet. It is typical for a pit to remain for a while when the swollen area is pressed with a finger (pitting oedema).

Fluid can accumulate not only in the legs but also in the abdominal cavity; this leads to complaints such as abdominal swelling, indigestion, and loss of appetite. The formation of oedema in the lungs (pulmonary oedema) is a life-threatening condition that makes breathing severely difficult for the patient and requires emergency treatment in intensive care conditions. If your shoes suddenly start feeling tight or you notice unexplained swelling in your legs, a medical evaluation is a must.

Fainting (Syncope)

Fainting related to heart diseases (cardiac syncope) is a condition that usually lasts for a few minutes, develops suddenly, and involves a complete loss of consciousness. It occurs as a result of a temporary decrease or halt in blood flow to the brain. The patient cannot respond to verbal or painful stimuli while unconscious. Most of the time, severe palpitations, chest pain, or a sudden blackout can be felt beforehand.

Cardiac syncopes are generally recurrent and progressive in nature. Severe narrowing of the heart valves, dangerous rhythm disorders, or heart muscle diseases can pave the way for fainting. Such patients absolutely require advanced testing. In addition to basic examinations like echocardiography, stress tests, and rhythm Holter monitors, an electrophysiological study may be recommended for some patients to examine the heart's electrical pathways in detail.

Cyanosis (Bluish Discolouration)

Cyanosis is a bluish or purplish colour change that occurs on the skin, especially on the fingertips and toes, lips, and the tip of the nose, due to insufficient oxygen reaching the tissues. The blood's oxygen saturation dropping below a certain level causes this colour change.

While it can indicate congenital heart diseases (like a hole in the heart), severe heart failure, and advanced heart valve diseases, serious lung diseases like COPD can also cause cyanosis. An increase in bluish discolouration, especially during exertion or crying (in babies), is a finding that must be evaluated urgently for heart health.

Quick Fatigue

Quick fatigue is a common complaint in daily life and is usually attributed to stress or a busy work schedule. Numerous illnesses such as anaemia, vitamin deficiencies, thyroid diseases, and high or low blood pressure can cause quick fatigue. However, this condition can also be one of the earliest symptoms of heart failure or coronary artery disease.

Especially in the elderly, if there is a known coronary heart disease or heart valve disease, getting tired more quickly than before and feeling the need to rest while doing daily chores should be considered an important symptom. If you experience a feeling of exhaustion while carrying groceries from the local bazaar or climbing a flight of stairs, your heart might be sending you a message that its capacity is being strained.

Hypertension (High Blood Pressure)

Hypertension is when the blood pressure value measured by a doctor on at least two separate days is 130/90 mmHg or higher. Before an accurate blood pressure measurement, the person must have rested in a quiet environment for 15-20 minutes and must not have consumed tea, cigarettes, or coffee in the last half hour. For suspected or newly diagnosed patients, wearing a 24-hour blood pressure Holter monitor is recommended to see blood pressure fluctuations throughout the day.

Hypertension is seen in about 25% of the population, and this rate increases with age. It is much more common in 60% of people over the age of 60, those who are overweight, and those with a family history of high blood pressure. This "silent killer," which causes no complaints in its initial stages, can cause symptoms such as headaches, excessive sweating, fatigue, ringing in the ears, blurred vision, restlessness, and a burning sensation at the back of the neck as blood pressure rises significantly. If left untreated, it leads to irreversible damage such as heart attacks, strokes, and kidney failure. Therefore, blood pressure medications must be used regularly and strictly at the dose recommended by the doctor.

Heart Disease Symptoms in Women

There is a misconception in society that a heart attack is mostly a male-specific disease; however, in the post-menopausal period, the risk of heart disease in women equals that of men. Heart disease symptoms in women can appear in more atypical (different) ways rather than classic chest pain. This situation leads to delayed diagnosis and complaints often being confused with acid reflux, muscle pain, or panic attacks.

Instead of a crushing feeling in the chest, female patients may feel pain in the back, between the shoulder blades, in the jaw, or in the neck. Unexplained extreme fatigue, shortness of breath, cold sweating, nausea, and vomiting are among the most common early warning signs of a heart attack in women. Especially if you have risk factors such as diabetes, high blood pressure, or smoking, you should never underestimate such atypical symptoms.

What is a Silent Heart Attack?

A silent heart attack, as the name suggests, is a condition where the person does not realise they are having a heart attack, and dramatic symptoms like classic chest pain and shortness of breath are not experienced. Most of the time, a silent heart attack is diagnosed by chance when damage to the heart is seen during a routine ECG taken months or years later.

Especially in people who have been treated for diabetes for many years, the sensation of pain may decrease due to nerve ending damage (neuropathy). During a heart attack, these patients may only feel mild indigestion, temporary weakness, or sweating and brush the situation off. Silent heart attacks are just as dangerous as symptomatic ones and leave permanent damage to the heart. Therefore, it is of vital importance for people in the risk group to have regular cardiological check-ups.

How is a Heart Condition Recognised and Diagnosed?

The diagnosis of heart diseases begins with a detailed physical examination by a cardiology specialist and listening to the patient's complaints. Today, highly advanced and painless methods are used for a definitive diagnosis. While the heart's electrical activity is measured with Electrocardiography (ECG), the heart's valves, wall movements, and pumping power are detailed using ultrasonic sound waves with Echocardiography (ECHO).

A stress test (treadmill) is the process of increasing the heart's workload by having the patient walk on a treadmill while recording an ECG; it is very effective in detecting hidden vascular blockages. Rhythm and blood pressure Holter devices catch abnormalities in daily life by recording the patient's 24-hour data. When deemed necessary, coronary angiography or computed tomography (virtual angio) methods are used to definitively see the internal structure of the heart vessels.

When to Visit the Emergency Department?

Time is of the essence in heart diseases. When certain symptoms appear, waiting at home or resting and saying "it will pass soon" can lead to irreversible consequences. If you experience any of the following complaints, you should call the 112 Emergency Call Centre without wasting time:

• Severe pain in the middle of your chest lasting longer than 15 minutes, in the form of pressure, squeezing, or a feeling of heaviness.
• Pain radiating to the left arm, shoulders, neck, jaw, or back.
• Cold sweating, nausea, vomiting, or dizziness accompanying chest pain.
• Sudden, severe shortness of breath that creates a feeling of suffocation.
• Unexplained and sudden loss of consciousness (fainting).

Heart Health and the Treatment Process at BHT CLINIC

To protect your heart health and identify potential risks early, it is of great importance to choose a centre with an expert team and advanced technology. The BHT CLINIC İstanbul Tema Hastanesi Cardiovascular Surgery and Cardiology departments offer world-class services to our paediatric and adult patients with a multidisciplinary approach.

In our hospital, advanced treatments such as coronary bypass, heart valve repairs, and minimally invasive surgery (surgeries performed with small incisions) are meticulously performed. With our 24/7 emergency department and fully equipped cardiovascular intensive care units, heart attacks are intervened with instantly. To not leave your heart health to chance and not postpone your complaints, you can benefit from our check-up programmes by booking a cardiology appointment at a time that suits you best.

Frequently Asked Questions

What does the face of someone with heart disease look like?

In people with heart failure or severe valve disease, a bluish/purplish colour change (cyanosis) can be seen on the lips, tip of the nose, and cheeks because sufficient oxygen does not reach the tissues. Additionally, in advanced heart failure, swelling (oedema) or extreme paleness in the face and eyelids may also be noticed.

Where does heart pain occur and where does it radiate?

Typical heart pain is usually felt right in the middle or slightly to the left of the breastbone, over a wide area. This pain frequently radiates to the left arm, shoulders, neck, lower jaw, and back. Pinpoint pains that can be pointed out with a finger or sharp pains when breathing in and out are generally not of cardiac origin.

How many days in advance do heart attack symptoms start?

Although a heart attack starts suddenly without any warning in some patients, many people may experience precursor symptoms days or weeks before the attack. Progressively increasing fatigue, short-lasting chest pressure even with mild exertion, sleep disturbances, and unexplained shortness of breath can be early signals of an approaching heart attack.

Can gas and burning in the stomach be a symptom of a heart attack?

Yes, especially in the blockage of the vessels feeding the lower wall of the heart (inferior myocardial infarction), the pain can radiate to the stomach area. Patients may describe this condition as severe indigestion, trapped gas, or heartburn. An ECG must definitely be taken for stomach pains that do not pass with antacid medications and are accompanied by sweating.

When are heart palpitations dangerous?

If palpitations are accompanied by chest pain, shortness of breath, dizziness, blackouts, or fainting, the situation is dangerous. Additionally, palpitations that start suddenly while at rest, are very fast (over 120 beats per minute), and are irregular require an urgent medical evaluation.

This article is for informational purposes only; please consult your doctor for diagnosis and treatment.