You may know the well-publicized signs of heart attack. But are other forms of heart disease creeping up on you or a loved one?
"When we think about heart disease, most people jump right to heart attack -- waking up clutching the chest with chest pains. But that's only the tip of the iceberg when it comes to heart disease," says cardiologist Lawrence Phillips, MD, assistant professor in the Leon H. Charney Division of Cardiology at NYU Langone Medical Center in New York.
It's a myth that all symptoms of heart disease are obvious. The following stealthy symptoms might seem far from your heart, but they way warrant a trip to your doctor.
1. New Aches and Pains
You've probably said to yourself, "I used to be able to....(fill in the blank), but now I have to stop because I get (fill in the blank)." Though this sounds benign, this could be your body's way of telling you something.
A change in function from what's normal for you is one of the key symptoms of heart trouble. Look at it this way: Your heart is your body's engine, pumping blood to fuel all your movements. If you notice a different reaction to an everyday activity, consider it like a warning light on your car dashboard, but in this case a sign of something potentially amiss with your heart's valves or electrical system.
Next steps: Don't dismiss a change in your response to physical exertion by saying, "Oh, I'm getting old" or "I must be out of shape." Find out for sure what the cause is. Especially if you see a pattern, get a physical exam. "There has to be a reason for the change," says Dr. Phillips.
2. Erectile Dysfunction
Trouble getting an erection is often blamed on age or disinterest. Often, however, the problem is an issue of adequate blood flow. Men who have this symptom are far more likely to have another kind of artery problem concerning the heart.
In 2013 a study done in Australian tracked more than 90,000 men. The study found that the worse the erectile dysfunction, the more heart disease and risk of early death a man had. Even those with mild or moderate erection problems were found to be at greater risk of heart attack or early death. Other studies have echoed this: Men with erectile dysfunction are twice as likely to also have cardiovascular disease or to die of a heart attack, according to a study of more than 1,500 men published in the journal Circulation in 2010.
"Arteries are arteries -- problems with blood vessels can affect blood flow to the heart as well as the penis," says cardiologist Lawrence Phillips.
Next steps: Don't be shy about getting erectile problems checked out by your doctor. Viagra treats the symptom but doesn't resolve the underlying issue. (Women: Unfortunately there is less research on sexual response and heart health.)
3. Holiday-Heart Syndrome
Many people notice a sudden jump in heart rate during exercise, which is normal. However, have you ever had that feeling of a fluttery heart following a bout of drinking? So-called "holiday heart syndrome" -- overdrinking, overeating, and getting too little sleep -- can lead to atrial fibrillation or an irregular heart beat.
"You might feel it that same evening, or within the next 12 hours," Langone Medical Center's Lawrence Phillips says. Atrial fibrillation is an irregular heartbeat that can cause fluttering in the chest and dizziness that lasts more than a few seconds.
Next steps: If you notice this happening repeatedly, mention it to your doctor. Try to find a pattern of when the symptoms start and report that to your doctor as well.
4. Swelling Feet and Ankles
Notice puffy ankles and feet after a long day at the office? Do your shoes seem tighter than they were earlier in the day? The accumulating fluid is an excess that is being pushed out from your vessels and into the skin.
While the swelling can be a temporary problem caused by things like hormonal changes (including pregnancy), a salty diet, or medications, it may also reflect faulty pumping action of the heart. When blood can't be pushed forward, it tends to back up into the veins. Gravity then brings it to the legs.
Next steps: Keep an eye out. If swelling is a change for you and you aren't sure why, get it checked by your doctor. People with diabetes should take special caution; since diabetics are at increased risk for heart disease.
5. Dizziness
While feeling dizzy can happen for many reasons, heart disease is actually close to the top of the list. An irregular heart beat or more advanced valve disease may be the cause. The valves of the heart need to open and close to move blood, however when calcium deposits narrow the aortic valve it can't open more than a crack. This lack of sufficient blood to the brain can lead to feeling light-headed.
Some people feel especially feel dizzy when they stand up (a rapid drop in blood pressure called "orthostatic hypotension"). People with orthostatic hypotension are more likely to develop heart disease, according to research in the journal Hypertension in 2012.
Next steps: Pay close attention to whether you're also having these other symptoms along with your dizziness. Things like shortness of breath, feeling faint with physical exertion, passing out, or having chest pain. Although a one time bout may not be any cause for worry, an ongoing pattern is worth a visit to the doctor.