Chances are you’re aware of the classic signs of a heart attack: the crushing chest pain, the shortness of breath. But what about heart disease? This killer doesn’t always strike with a big bang; some indicators of ticker trouble are far less obvious than others. Here are 10 little-known signs that you may have heart problems.
1. You struggle to breathe when lying flat
If breathing is hard when you sleep on your back but often improves when you sit upright, you may have fluid buildup in the lungs, which can indicate heart failure. “When you lie flat, your blood volume gets redistributed,” says Jim Liu, M.D., a cardiologist at the Ohio State University Wexner Medical Center. “The heart can have problems pumping this extra blood volume, and this can lead to increased shortness of breath due to increased fluid in the lungs.” This condition, known as orthopnea, needs a doctor’s immediate attention.
Snoring can also be a red flag. Sleep-disordered breathing, such as sleep apnea, “is associated with metabolic syndrome, which is associated with heart disease,” says Eleanor Levin, M.D., clinical professor of cardiovascular medicine at the Stanford University School of Medicine. Between 40 and 80 percent of people in the United States with heart disease also have obstructive sleep apnea, according to the American Heart Association. Sleep apnea can worsen heart disease, which in turn can worsen sleep apnea.
2. You have leg or hip pain (or both) while walking
Lower-body pain can result from injuries, arthritis or being out of shape, but it may also signal circulation problems in the legs from peripheral artery disease. “Much like blockages in the heart arteries can cause heart attacks, blockages in the leg arteries can cause pain when walking,” says Deepak L. Bhatt, M.D., director of Mount Sinai Heart and Dr. Valentin Fuster Professor of Cardiovascular Medicine, Icahn School of Medicine at Mount Sinai Health System. If large leg arteries are clogged, smaller arteries in the heart probably are, too.
Circulation-related pain often occurs when you exercise and ends when you stop (the obstruction limits the amount of oxygen reaching the muscles). “When you stop walking, you don’t need that much oxygen and the pain goes away,” says Levin.
3. You experience erectile dysfunction …
Diabetes or chronic stress can cause erectile dysfunction (ED), but it may be a sign of budding heart disease, says Michael Blaha, M.D., director of clinical research at the Ciccarone Center for the Prevention of Cardiovascular Disease at Johns Hopkins Medicine in Baltimore, Maryland. ED is often a blood-flow problem, and risk factors — from smoking to hypertension — are similar for vascular ED and atherosclerotic cardiovascular disease (hardening of the arteries). The root cause of both issues is endothelial dysfunction, in which blood vessels have difficulty expanding and contracting properly, which reduces blood flow to the heart and the penis.