Heart Disease and Diabetes

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12 Possible Heart Symptoms Never to Ignore

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Heart disease is the No. 1 killer of U.S. men and women, accounting for 40% of all U.S. deaths. That’s more than all forms of cancer combined.

Why is heart disease so deadly? One reason is that many people are slow to seek help when symptoms arise. Yes, someone gripped by sudden chest pain probably knows to call 911. But heart symptoms aren’t always intense or obvious, and they vary from person to person and according to gender.

Because it can be hard to make sense of heart symptoms, doctors warn against ignoring possible warning signs, toughing them out, waiting to see if they go away, or being quick to blame them on heartburn, muscle soreness, or other less serious, noncardiac causes. That’s especially true for men and people over 65, as well as for people with other cardiac risk factors, such as high cholesterol or blood pressure, obesity, smoking, diabetes, or a family history of heart disease.

“The more risk factors you have, the higher the likelihood that a symptom means something is going on with your heart,” says David Frid, MD, a cardiologist at the Cleveland Clinic. “People often don’t want to admit that they’re old enough or sick enough to have heart trouble. Putting off treatment for other medical problems might not be so bad, but a serious heart problem can mean sudden death. It’s better to go in and get it evaluated than to be dead.”

12 Possible Heart Symptoms Never to Ignore

Here are a dozen symptoms that may signal heart trouble.

1. Anxiety. Heart attack can cause intense anxiety or a fear of death. Heart attack survivors often talk about having experienced a sense of “impending doom.”

2. Chest discomfort. Pain in the chest is the classic symptom of heart attack, and “the No. 1 symptom that we typically look for,” says Jean C. McSweeney, PhD, RN, associate dean for research at the University of Arkansas for Medical Sciences College of Nursing in Little Rock and a pioneer in research on heart symptoms in women. But not all heart attacks cause chest pain, and chest pain can stem from ailments that have nothing to do with the heart.

Heart-related chest pain is often centered under the breastbone, perhaps a little to the left of center. The pain has been likened to “an elephant sitting on the chest,” but it can also be an uncomfortable sensation of pressure, squeezing, or fullness. “It’s not unusual for women to describe the pain as a minor ache,” McSweeney says. “Some women say the pain wasn’t bad enough even to take a Tylenol.”

Women, more so than men, can also experience a burning sensation in their chest, rather than a pressure or pain.  “Sometimes people make the mistake that the pain comes from a stomach problem,” says Nieca Goldberg, MD, clinical associate professor of medicine at the NYU Langone Medical Center in New York City and another expert on women’s heart symptoms.

3. Cough. Persistent coughing or wheezing can be a symptom of heart failure — a result of fluid accumulation in the lungs. In some cases, people with heart failure cough up bloody phlegm.

4. Dizziness. Heart attacks can cause lightheadedness and loss of consciousness.  So can potentially dangerous heart rhythm abnormalities known as arrhythmias.

5. Fatigue. Especially among women, unusual fatigue can occur during a heart attack as well as in the days and weeks leading up to one. And feeling tired all the time may be a symptom of heart failure.

Of course, you can also feel tired or fatigued for other reasons. How can you tell heart-related fatigue from other types of fatigue?

“If you don’t feel well and all the wind is knocked out of your sails, don’t try to figure it out on the Internet or from a book,” says Goldberg.  “Wasting time is dangerous.”

6. Nausea or lack of appetite. It’s not uncommon for people to feel sick to their stomach or throw up during a heart attack. And abdominal swelling associated with heart failure can interfere with appetite.

7. Pain in other parts of the body. In many heart attacks, pain begins in the chest and spreads to the shoulders, arms, elbows, back, neck, jaw, or abdomen. But sometimes there is no chest pain — just pain in these other body areas.  The pain might come and go.

Men having a heart attack often feel pain in the left arm. In women, the pain is more likely to be felt in both arms, or between the shoulder blades.

8. Rapid or irregular pulse. Doctors say that there’s nothing worrisome about an occasional skipped heartbeat. But a rapid or irregular pulse — especially when accompanied by weakness, dizziness, or shortness of breath — can be evidence of a heart attack, heart failure, or an arrhythmia. Left untreated, some arrhythmias can lead to stroke, heart failure, or sudden death.

9. Shortness of breath. People who feel winded at rest or with minimal exertion might have a pulmonary condition like asthma or chronic obstructive pulmonary disease (COPD). But breathlessness could also indicate a heart attack or heart failure.

“Sometimes people having a heart attack don’t have chest pressure or pain but feel extremely short of breath,” Goldberg says. “It’s like they’ve just run a marathon when they haven’t even moved.” During a heart attack, shortness of breath often accompanies chest discomfort, but it can also occur before or without chest discomfort.

10. Sweating. Breaking out in a cold sweat is a common symptom of heart attack. “You might just be sitting in a chair when all of a sudden you are really sweating like you had just worked out,” Frid says.

11. Swelling. Heart failure can cause fluid to accumulate in the body. This can cause swelling (often in the feet, ankles, legs, or abdomen) as well as sudden weight gain and sometimes a loss of appetite.

12. Weakness. In the days leading up to a heart attack, as well as during one, some people experience severe, unexplained weakness. “One woman told me it felt like she couldn’t hold a piece of paper between her fingers,” McSweeney says.

By David Freeman                                                                                                                                                           © 2010 WebMD, LLC. All rights reserved.

 

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High-Normal Blood Pressure Raises Heart Risks in Men

Earlier Study Showed Same Thing in Women

Jan. 17, 2012 — Having high blood pressure in middle age is a major risk factor for developing atrial fibrillation later in life, and now new research links high-normal-range blood pressure with an increase in risk.

More than 2 million mostly older Americans have the heart rhythm disorder known as atrial fibrillation, which greatly increases their risk for stroke, heart failure, and death.

Researchers followed about 2,000 Norwegian men for an average of 30 years, during which time 270 developed atrial fibrillation.

Men whose systolic blood pressure (the upper number) was in the high-normal range at the start of the study were 50% more likely than men with normal blood pressure to develop the heart rhythm condition.

An earlier study in women who were followed for an average of 14 years also showed high-normal blood pressure to be associated with a higher risk for atrial fibrillation.

Prehypertension and Atrial Fibrillation

In the United States, high blood pressure is defined as a systolic reading of 140 or higher and a diastolic reading of 90 or more.

High-normal blood pressure, also known as prehypertension, is generally defined as having a systolic reading of between 120 and 139 and/or a diastolic reading of 80 to 89.

Atrial fibrillation is characterized by an irregular — and sometimes rapid — heartbeat resulting when the two upper chambers and two lower chambers of the heart are not contracting in sync.

Symptoms can include heart palpitations, shortness of breath, general weakness, or no symptoms at all.
In an effort to determine if the earlier findings in women also applied to men, researcher Irene Grundvold, MD, and colleagues from Norway’s Oslo University Hospital analyzed data from a study of men who were in their 40s and 50s when first examined in the early- to mid-1970s.

The men were followed for up to 35 years.

The study revealed that:

  • Men with systolic blood pressure readings of 140 or higher when they entered the study had a 60% increased risk of developing atrial fibrillation over the next three decades, compared to men with systolic readings below 128.
  • Men with systolic readings of 128 to 138 at at the start of the study had a 50% increase in risk.
  • Men with diastolic readings of 80 or higher were 79% more likely than those with lower diastolic blood pressure to develop atrial fibrillation over the next three decades.

High-Normal BP Is Patient Wake-Up Call, Says Doctor

On average, the men who developed atrial fibrillation did so around two decades after entering the study.

The findings appear in the February issue of the American Heart Association (AHA) journal Hypertension.
Prehypertension is common in people with metabolic syndrome, which is a group of risk factors associated with an elevated risk for heart disease, stroke, and type 2 diabetes.

“This study is another example of a metabolic syndrome trait being associated with higher [heart disease and stroke] risk,” says AHA spokesman Roger Blumenthal, MD, who directs the Johns Hopkins Ciccarone Preventive Cardiology Center. Blumenthal says the findings should serve as a wake-up call for those with blood pressure readings in the high-normal range, adding that people with systolic blood pressure readings in the 130s and diastolic readings in the 80s should be counseled to make lifestyle changes that can improve the numbers.

“That means revving up your diet and exercise schedule and losing weight if you are overweight,” he says.

Earlier Study Showed Same Thing in Women
By Salynn Boyles
WebMD Health News
Reviewed byLaura J. Martin, MD

© 2012 WebMD, LLC. All rights reserved.