In many types of cardiovascular disease, there are symptoms that are common and well-recognized, such as chest pain in heart attack, while others are rare and go more unnoticed, such as shortness of breath, fatigue, sweating, nausea, and dizziness
A scientific statement from the American Heart Association, based on a new review of the latest research and published in the journal “Circulation,” highlights the most reported symptoms of various cardiovascular diseases, and suggests that men and women often experience different signals.
The statement also highlights how symptoms are experienced over time, which may be months or years apart depending on the condition, and across a spectrum of severity or intensity, and points to the long-term nature of cardiovascular disease development. They found that symptoms vary over time and by gender.
Cardiovascular disease is the leading cause of death worldwide. It includes several pathologies, including the 6 outlined in this scientific statement: heart attack, heart failure, valve disease, stroke, heart rhythm disorders and peripheral artery and vein disease.
“The symptoms of these cardiovascular diseases can profoundly affect quality of life, and a clear understanding of them is critical for effective diagnosis and treatment decisions. The scientific statement is a compendium of the »state of the science« detailing the symptoms associated with cardiovascular disease, the similarities or differences in symptoms between the conditions, and the sex differences in symptom presentation and reporting. Chair of the scientific statement writing committee, Corrine Y. Jurgens, an associate professor at Boston College’s Connell School of Nursing.
Due to its subjectivity, measuring symptoms is difficult. “Some people may not consider symptoms such as fatigue, sleep disturbances, weight gain and depression as important or related to cardiovascular disease. However, research indicates that subtle symptoms such as these can predict acute events and the need for hospitalization. A broader definition of what constitutes a »significant« symptom is warranted, Jurgens clarifies.
Heart attack
Heart attack is one of several conditions that fall under the broad category of acute coronary syndrome, a term that refers to any heart condition caused by a sudden loss of blood flow to the heart. The most common symptom, particularly of heart attack, is chest pain, which is often described as pressure or discomfort, and can radiate to the jaw, shoulder, arm, or upper back. The most common concurrent symptoms are shortness of breath, sweating or cold sweat, unusual fatigue, nausea, and dizziness. These additional symptoms have often been called “atypical,” which may be due, according to a recent advisory from the American Heart Association, to the lack of women included in the clinical trials from which the symptom lists were derived. Women are more likely than men to report more red flags besides chest pain.
Heart failure
The difficulty breathing it is a classic symptom of heart failure and a common reason for seeking medical attention. However, it is necessary to know the early and more subtle signs to consult with a health professional. This may include gastrointestinal symptoms such as upset stomach, nausea, vomiting, and loss of appetite; fatigue; exercise intolerance (related to fatigue and shortness of breath); insomnia; pain (chest and others); mood disturbances (mainly depression and anxiety); and cognitive dysfunction (brain fog, memory problems).
Women with heart failure report a wider range of symptoms, are more likely to have depression and anxiety, and report a lower quality of life compared to men with heart failure. As with a heart attack, women are more likely than men to report different symptoms. In heart failure, they report nausea, palpitations, and digestive changes, as well as higher levels of pain (in other areas of the body, not just the chest), swelling, and sweating.
valve disease
Heart valve disease is a common cause of heart failure and shares the symptom of difficulty breathing. Problems with the heart valves (the structures that control the flow of blood between the chambers of the heart) include narrowed or hardened valves (stenosis), valves that close incorrectly (prolapse), allowing blood to flow backwards (regurgitation), or valves incorrectly formed (atresia). In mild cases of valve disease, people may not have symptoms for years and then progressively develop more symptoms similar to those associated with heart failure. Valve disease can also cause high blood pressure in the lungs, or pulmonary hypertension. One of the most serious and common forms of valve disease is aortic stenosis, which occurs when the aortic valve narrows and restricts blood flow from the heart.
Women with aortic stenosis report shortness of breath, exercise intolerance and physical frailty more often than men, and they are more likely to have lower scores on a standard grading system for heart failure. Men with valve disease are more likely to report chest pain than women.
Stroke
A stroke occurs when a blood vessel to the brain becomes blocked or bursts, usually causing recognizable symptoms that require emergency help. To recognize stroke symptoms that require immediate medical attention, the American Stroke Association recommends everyone remember these: droopy face, weak arms, slurred speech. Other symptoms of stroke are confusion, dizziness, loss of coordination or balance, and visual changes. Recognizing the symptoms of stroke is critical, as prompt treatment can help prevent or reduce the chance of long-term disability or death.
Women experiencing a stroke are more likely than men to have other, lesser-known symptoms: headache, altered mental status, coma, or stupor. Stroke can also affect thinking, which, in turn, can affect an individual’s ability to recognize new or worsening symptoms.
rhythm disorders
Rhythm disorders, called arrhythmias, are often described as the sensation of an abnormal heartbeat or palpitations that may be irregular, rapid, or jerky. Other symptoms include fatigue, shortness of breath, and dizziness. Less commonly, some people with heart rhythm disorders may experience chest pain, dizziness, fainting, and anxiety.
Women and young adults with rhythm disorders are more likely to experience palpitations, while men are more likely to experience no symptoms. Older adults are more likely to have unusual symptoms or no symptoms at all. Differences in warning signs have also been found among people of various racial and ethnic groups. The data indicates that black adults report experiencing more heart palpitations, shortness of breath, exercise intolerance, dizziness, and chest discomfort compared to Hispanic or white people.
disease of veins and arteries
Peripheral arterial disease (PAD) affects the arteries of the lower extremities, reducing the blood supply to the legs. People with this condition may have no symptoms or may develop the classic symptom of pain in one or both calf muscles that occurs when walking and disappears with rest. However, pain in other parts of the legs and in the feet and toes are the most common symptoms. PAD with symptoms is associated with an increased risk of heart attack and stroke, with men having a higher risk than women.
Depression also occurs frequently among people with PAD, especially women and people who are older or from various racial and ethnic groups.
Peripheral vein disease may not cause symptoms or it may cause leg pain. Typical leg-related symptoms include leg pain and discomfort, leg heaviness or tightness, fatigue, cramps, restless leg syndrome, and skin irritation. In one study, adults under the age of 65 were more likely than older adults to report pain, heaviness, discomfort, and fatigue. Symptoms of vein disease sometimes occur even when there are no visible signs of the condition.
“Symptom relief is an important part of managing cardiovascular disease. It is important to recognize that many symptoms vary in their occurrence or severity over time, that women and men often experience symptoms differently, and that factors such as depression and cognitive function may affect detection and reporting of symptoms. . Monitoring and measuring symptoms with tools that properly account for depression and cognitive function can help improve patient care by more quickly identifying people who may be at higher risk.”