When it comes to heart disease, it’s easy to think all symptoms are heart-related, so the absence of heart-related symptoms means you’re in the clear. But you could have heart disease and not even know it because some symptoms aren’t quite that obvious, especially in women.

The term “heart disease” refers to several types of heart conditions, which can produce various different symptoms depending on which condition you have. The most common type of heart disease in the United States is coronary artery disease (CAD), which affects the blood flow to the heart.

Heart disease is the leading cause of death in the United States, causing one in four deaths. In total, almost half of American adults have at least one type of heart disease, while many more have risk factors associated with heart disease, which means getting to know all of the potential symptoms can be potentially lifesaving, especially the lesser-known ones.

The Less-Obvious Signs of Heart Disease

Even though lesser-known symptoms can be easy to brush off or explain away, oftentimes they’re a bit of a canary in the coal mine, says Tulio Diaz, M.D., a cardiologist and physician on the medical staff of Texas Health Dallas and with Texas Health Heart & Vascular Specialists, a Texas Health Physicians Group practice.

“Everyone thinks with heart disease, the first symptom is chest pain or pressure in the chest, but that isn’t always the case. Often patients will tell me they’ve been feeling more tired or weak than usual, but they don’t think it’s heart-related,” Diaz explains. “When you see these warning signs, you should seek medical attention because it could be your body letting you know something is wrong with your heart. There’s nothing wrong with getting a bit of reassurance, especially if you already have risk factors related to heart disease.”

Extreme Fatigue

If you’ve ever had the flu, you know all too well what extreme fatigue can feel like; that complete lack of energy where you feel totally drained and struggle to get through the day. But extreme fatigue can be an indicator of early heart disease, especially when it seems to come out of nowhere.

“If you notice a sudden change in energy level, that should trigger the alarms,” Diaz says. “I often hear patients try to explain it away as, ‘oh I’m just getting older,’ or ‘I’m working too much, I have too much stress, that’s what it is,’ but if there’s a sudden change in energy and especially if it doesn’t improve after rest, it’s important to seek medical attention.”  

Shortness of Breath

Occasionally losing your breath after walking up a particularly long set of stairs or a long distance is normal. So is experiencing shortness of breath during an intense workout. But Diaz notes if you’re having difficulty catching your breath when you’re at rest or after an activity that doesn’t usually cause you to catch your breath, it could be a sign of an underlying heart health issue.

“Increased shortness of breath, especially with general daily activities of living should be a cause for concern,” he says. “Of course, when you exercise, you get out of breath, but patients with heart disease, especially in the early stages, get out of breath out of proportion to the activity they’re doing, such as walking from your desk to the bathroom or from your car to the store.”

Sudden Weakness

While you may not describe yourself as a modern-day Popeye, experiencing a sudden decrease in your strength can be a warning sign that your heart is having a hard time.

“If you notice you’re suddenly feeling very weak and tired all the time and you get out of breath really easily and it’s happening when you’re just resting or you’re doing something that wouldn’t normally cause that kind of reaction, it’s time to get checked out,” Diaz says. “Even if we do a workup and your heart is fine and the symptoms are related to something else, it’s always worth getting some reassurance.”

Dizziness or Lightheadedness

We’ve all experienced dizziness at some point in our lives, especially if you’ve just walked off a twisting and turning fair ride or stood up a little too fast from your chair. But if you’re feeling dizzy or lightheaded without any of these explainable activities, it could be a sign your heart isn’t pumping efficiently.

Difficulty Sleeping

Chances are you may know that getting a good night’s sleep is important for many factors of our health, including our heart. Sleep gives our bodies time to restore and recover. But did you know it can be a two-way street? While a lack of sleep can impact your heart health, an undiagnosed heart issue may present itself by impacting your ability to get some shuteye.

If you notice it’s harder to breathe when you lie down for rest, have a general feeling of discomfort that makes it hard to drift off to sleep or you typically fall asleep easily and suddenly have a hard time, it may be worth getting a checkup.  

What Testing Can Look Like

The thought of getting a checkup for your heart can be frightening. You may wonder what testing will look like and what you’ll do if they find something.

But Diaz says a checkup almost always starts with your primary care physician, someone you should already know and trust, who can do a preliminary exam and some minor testing to see if you need to be referred to a cardiac specialist or not.

“Your doctor will provide a good exam and will always look at your risk factors, such as heart disease, diabetes, high blood pressure, high cholesterol and family history,” Diaz explains. “Then they’ll most likely perform an electrocardiogram (EKG) which provides a reading of your heart’s electrical activity. Your doctor will then use all of this information to decide if there’s a need to be referred to a cardiac specialist for further testing. You can get a checkup, and everything can come back OK, but you can’t let fear keep you from getting treatment; that will only delay things.”

The Takeaway

Diaz knows all too well how often these symptoms can be overlooked, but the fact is heart disease is the leading cause of death in both men and women in the U.S, even more than all the cancers combined.

“There’s a reason why heart disease is called the silent killer. We’re seeing heart disease presenting in younger and younger populations nowadays. No longer is it someone in their 50s; we’re seeing more people in their 30s and 40s coming to the hospital with heart attacks and other heart-related issues, so if you have risk factors or you notice symptoms, get screened,” Diaz says.

He adds that it’s also important to get screened if you’re about to start a new exercise program or increase your physical activity.

“I don’t want that to scare anyone off from working out. Exercising is great for your heart, but if it’s been a while since you’ve been active or you’re increasing your activity, it’s always better to be safe and get a clean bill of health from your doctor before starting,” he says. 

If you suspect you have symptoms of heart disease, find a heart and vascular specialist today.