Do people with early heart disease have symptoms?

Heart disease doesn't always begin with the kind of severe chest pain shown on TV. You may notice that walking up the stairs leaves you winded. You might feel unusually tired, even after a full night's sleep. Or you may begin to notice a fluttering sensation in your chest. 

It's easy to connect these changes to stress, aging, poor sleep or being out of shape. And those may be the reasons. But if they continue or start to affect your everyday routine, it's worth checking with your doctor to rule out signs of a heart condition.

“Knowing the warning signs may help you find heart disease early,” says Dr. Wesam Ostwani, a cardiologist at Ascension Illinois. “It’s also important to pay attention to your overall heart health. A few simple habits can go a long way in helping you recognize potential problems early."

Dr. Ostwani explains the early signs of heart disease to look for and when you should share those details with your doctor to understand what may be causing it.

H2: Can you have heart disease without symptoms?

Yes. Some types of heart disease might not cause noticeable symptoms, particularly in the earlier stages. For some people, the first sign may be a heart attack, or a stroke with some abnormal heart rhythms or another complication. 

That’s one reason routine care matters — even when you feel well, says Dr. Ostwani. Your healthcare provider can check your blood pressure numbers, cholesterol and blood sugar and talk with you about other factors that may affect your risk for heart disease. 

What are the early signs of heart disease?

Heart disease is a broad term for conditions that affect the heart and blood vessels. Coronary artery disease, the most common type of heart disease, develops when plaque builds up in the arteries that supply blood to the heart. Other conditions can affect the heart’s rhythm, valves or ability to pump blood

Possible signs of heart disease include chest pain or pressure, shortness of breath, unusual fatigue, dizziness, swelling in the legs or feet, discomfort or pain that spreads to the jaw, neck, back, shoulders or arms, and passing out or fainting. 

These symptoms can have many causes, and having one doesn’t necessarily mean you have heart disease, explains Dr. Ostwani. What matters is noticing a change from your usual health. It can also help to remember when a symptom occurs and whether activity or rest affects it. 

Common early signs of heart disease

Chest pain or pressure

Chest discomfort is one of the most common symptoms of coronary artery disease. It can happen when narrowed arteries limit blood flow to the heart muscle, especially when the heart is working harder during physical activity or emotional stress. 

The sensation may feel like pressure, tightness, heaviness or squeezing. It may also spread to the shoulders, arms, back, neck or jaw.

“Heartburn, a strained muscle and certain lung conditions can cause similar discomfort,” explains Dr. Ostwani. “While a symptom itself doesn’t identify the cause, new or recurring chest discomfort shouldn’t be ignored.” 

Shortness of breath

When a heart condition affects how well the heart pumps blood, breathing may become more difficult. You may notice that an activity that once felt manageable — like walking upstairs or completing everyday tasks — now leaves you winded.

Shortness of breath can also occur with lung conditions, anemia, infections and other health problems, Dr. Ostwani says. Pay attention if you’re getting winded more easily, need to stop more often or feel short of breath while resting.

Unusual fatigue

Everyone feels tired sometimes. “Persistent fatigue can sometimes occur when the heart isn’t delivering enough blood to meet the body’s needs during activity,” he says.

A change in energy may be easy to overlook, especially if it develops over time. Let your doctor know if fatigue makes it harder to work, exercise or manage your usual routine — especially if it occurs with shortness of breath, dizziness or chest discomfort. 

Pain in the jaw, neck, back or arm

Heart-related pain isn't always felt in the chest. It can radiate to the jaw, neck, shoulders, back or left arm.

Pain in these areas can have many causes. When it’s more concerning is when it occurs with chest discomfort, shortness of breath, nausea or sweating. 

Dizziness, lightheadedness or a fluttering heartbeat

Dizziness or lightheadedness can happen for many reasons, including dehydration, medication side effects and changes in blood pressure. It may also be related to an abnormal heart rhythm, which can make the heart beat too quickly, too slowly or irregularly. 

“Some people notice this as a fluttering, pounding, racing or skipping sensation in the chest,” adds Dr. Ostwani. “These sensations are not always significant, but any new or recurring symptoms should be evaluated.” 

Swelling in the legs, ankles or feet

Swelling in the lower body can happen when fluid builds up. In some cases, this is related to heart failure, which happens when the heart doesn’t pump blood as well as it should, or when the heart becomes stiff and doesn't relax as well.

Swelling can also have other causes. If it continues or occurs with shortness of breath, fatigue or a sudden change in weight, it’s a good idea to get checked out.

Are heart disease symptoms different for women?

Women and men can have the same heart disease symptoms, including chest pain or pressure. However, women are more likely to experience symptoms like:

• Unusual fatigue
• Shortness of breath
• Nausea
• Dizziness 
• Pain in the jaw, neck or back

Because these symptoms can resemble other conditions, they can be overlooked.

When should you seek care?

See a healthcare provider if you have symptoms that are new, recurring, getting worse or happen during physical activity. 

“Before your visit, write down when the symptom began, what you were doing and whether anything made it better or worse,” says Dr. Ostwani. Depending on your symptoms and health history, your provider may recommend an examination, blood work, an electrocardiogram, a stress test, a Holter monitor to evaluate your heart health, or some other heart testing.

Call 911 immediately if you have chest pain or pressure that lasts more than a few minutes or goes away and comes back, severe shortness of breath, pain that spreads to your arm, jaw or back, or symptoms accompanied by fainting, nausea or a cold sweat. These may be signs of a heart attack and require emergency medical care.

If you think you may be having a heart attack, call 911 even if you aren’t sure, says Dr. Ostwani. Follow the emergency dispatcher’s instructions, and don’t drive yourself to the hospital. 

"Don't wait until symptoms become severe," says Dr. Ostwani. "Many heart conditions are more manageable when they're identified early. If something feels new, unusual or concerning, it's always worth getting checked."

Next steps and helpful resources

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