Common Symptoms of Heart Disease

By Richard N. Fogoros, M.D., About.com
Updated: December 28, 2007

Chest Pain or Chest Discomfort
Few symptoms are more alarming than chest pain. In the minds of many people, chest pain equals heart pain. And while many other conditions can cause chest pain, cardiac disease is so common - and so dangerous - that the symptom of chest pain should never be dismissed out of hand as being insignificant.

"Chest pain" is an imprecise term. It is often used to describe any pain, pressure, squeezing, choking, numbness or any other discomfort in the chest, neck, or upper abdomen, and is often associated with pain in the jaw, head, or arms. It can last from less than a second to days or weeks, can occur frequently or rarely, and can occur sporadically or predictably. This description of chest pain is obviously very vague, and as you might expect, many medical conditions aside from heart disease can produce symptoms like this.

You can read about the many causes of chest pain here. This article discusses the major causes of chest pain, as well as some of the main characteristics that help doctors make a diagnosis of what may be causing the chest pain.

This article discusses the evaluation of chest pain, and addresses the question: When should chest pain be considered an emergency?

Palpitations
Palpitations, an unusual awareness of the heartbeat, is an extremely common symptom. Most people who complain of palpitations describe them either as "skips" in the heartbeat (that is, a pause, often followed by a particularly strong beat,) or as periods of rapid and/or irregular heartbeats.

Most people with palpitations have some type of cardiac arrhythmia. Virtually any arrhythmia can cause palpitations, but the most common causes of palpitations are premature atrial complexes (PACs), premature ventricular complexes (PVCs), episodes of atrial fibrillation, and episodes of supraventricular tachycardia (SVT). Unfortunately, on occasion palpitations can be a manifestation of a more dangerous heart arrhythmia, such as ventricular tachycardia. Click here for a quick and easy review of heart arrhythmias.

Click here for a review of palpitations, their causes, and how they should be evaluated.

Lightheadedness or Dizziness
Episodes of lightheadedness or dizziness can have many causes, including anemia (low blood count) and other blood disorders, dehydration, viral illnesses, deconditioning (such as prolonged bed rest), diabetes, thyroid disease, gastrointestinal disturbances, liver disease, kidney disease, vascular disease, neurological disorders, the dysautonomias, vasovagal episodes, heart failure and cardiac arrhythmias. Because so many different conditions can produce these symptoms, anybody experiencing episodes of lightheadedness or dizziness ought to have a thorough and complete examination by a physician. And since disorders of so many organ systems can cause these symptoms, a good general internist or family doctor may be the best place to start.
Syncope (loss of consciousness)

Syncope is a sudden and temporary loss of consciousness, or fainting. It is a common symptom - most people pass out at least once in their lives - and often does not indicate a serious medical problem. However, sometimes syncope indicates a dangerous or even life-threatening condition, so when syncope occurs it is important to figure out the cause.

The causes of syncope can be grouped into four major categories, neurologic, metabolic, vasomotor and cardiac. Of these, only cardiac syncope commonly leads to sudden death. Here is an article on the cardiac causes of syncope, the most dangerous kind.

Fortunately, most syncope is not cardiac in nature, and thus is not life-threatening. Here is an article, that reviews the non-cardiac causes of syncope, then outlines what you should expect from your doctor when you or a loved one have had a syncopal episode.

Finally, here is an article on vasomotor (or vasovagal) syncope, by far the most common cause of this symptom.

Fatigue, lethargy or somnolence
Fatigue, lethargy or somnolence (daytime sleepiness) are very common symptoms. Fatigue or lethargy can be thought of as an inability to continue functioning at one's normal levels. Somnolence implies, in addition, that one either craves sleep - or worse, finds oneself suddenly asleep, a condition known as narcolepsy - during the daytime.

While fatigue and lethargy can be symptoms of heart disease (particularly, of heart failure), these common and non-specific symptoms can also be due to disorders of virtually any other organ system in the body. Similar to lightheadedness and dizziness, individuals with fatigue and lethargy need a good general medical evaluation in order to begin pinning down a specific cause.
Somnolence is often caused by nocturnal sleep disorders such as sleep apnea, restless leg syndrome or insomnia. All these sleep disturbances, however, are more common in patients with heart disease.

Shortness of breath
Shortness of breath is most often a symptom of cardiac or pulmonary (lung) disorders. Heart failure and coronary artery disease frequently produce shortness of breath. Patients with heart failure commonly experience shortness of breath with exertion, or when lying flat on their backs. They also can suddenly wake up at night gasping for breath, a condition known as paroxysmal nocturnal dyspnea. Coronary artery disease can manifest as shortness of breath on exertion. Other cardiac conditions such as valvular heart disease or pericardial disease can produce this symptom, as can cardiac arrhythmias.

Numerous lung conditions can produce shortness of breath including asthma, emphysema, bronchitis, pneumonia, or pleural effusion (a fluid accumulation between the lung and chest wall).
Shortness of breath is almost always a sign of a significant medical problem, and should always be evaluated by a doctor.