A new scientific statement from the American Heart Association was released today in Circulation. The statement summarizes the most recent research and highlights the symptoms of various cardiovascular diseases (CVDs) that are most frequently reported, noting that men and women frequently experience different symptoms.
The statement also emphasizes how symptoms are felt over time, sometimes months or years apart depending on the condition, and in a variety of degrees, emphasizing the gradual onset of cardiovascular disease. The scientific statement writing committee looked over recent studies on the signs of various cardiovascular conditions. They discovered that symptoms change with time and based on gender.
Across the globe and in the United States, cardiovascular disease is the biggest killer. It includes a number of diseases, six of which are discussed in this scientific statement: heart attack, heart failure, valve disease, stroke, problems with the heart’s rhythm, and peripheral artery and vein disease.
Why measure symptoms?
It is challenging to measure symptoms because of their subjectivity. If people don’t consider symptoms to be significant or connected to an existing medical problem, they might not recognize them or choose not to report them. Additionally, both disease state and symptoms may progress without any changes in the course of the disease.
Some people might not think of cardiovascular disease symptoms including fatigue, sleep difficulty, weight gain, and depression as significant or linked, according to the authors. However, research suggests that discrete symptoms like these may signify the necessity for hospitalization and acute events. It is necessary to provide “important” symptoms with a broader definition.
While there are many different forms of cardiovascular diseases, certain symptoms are prevalent and well-known while others are rare. For instance, the most typical and recognizable sign of a heart attack is chest pain. Shortness of breath, weariness, sweating, nausea, and lightheadedness are less common symptoms, though.
Establishing an individual’s baseline symptom profile and monitoring symptoms over time may be useful in spotting changes and any worsening of symptoms, according to Jurgens.
Signs you’re at risk of heart attack
Acute coronary syndrome (ACS), a general name for any cardiac condition brought on by a sudden reduction in blood supply to the heart, includes a number of conditions, including heart attack. Chest pain, which is commonly described as pressure or discomfort and may radiate to the jaw, shoulder, arm, or upper back, is the most frequently reported symptom of ACS, particularly heart attack. Shortness of breath, perspiration or a cold sweat, unusual fatigue, nausea, and lightheadedness are the most typical co-occurring symptoms. These additional symptoms have frequently been labeled as “atypical,” but according to a recent American Heart Association presidential advice, this description may have been inaccurate because there weren’t enough women participating in the scientific trials that produced the symptom lists. In addition to chest pain, women are more likely than men to report additional symptoms.
Signs you’re at risk of Heart failure
One of the most well-known signs of heart failure is shortness of breath, which also drives many adults with the condition to the doctor. Early, more subtle symptoms, on the other hand, should be recognized as warnings to speak with a medical expert. In addition to fatigue, exercise intolerance (caused by fatigue and shortness of breath), insomnia, pain in the chest and elsewhere, mood disturbances (primarily depression and anxiety), and cognitive dysfunction, these symptoms may also include gastrointestinal symptoms like upset stomach, nausea, vomiting, and appetite loss (brain fog, memory problems).
Compared to males with heart failure, women report a wider variety of symptoms, are more likely to experience sadness and anxiety and have a lower quality of life. Women are more likely than males to report various symptoms, just like a heart attack. Women with heart failure also experience swelling, sweating, nausea, palpitations, and changes in their digestive systems in addition to the discomfort that is more intense overall (not just in the chest).
According to Y. Jurgens, Ph.D., R.N., A.N.P., FAHA, an associate professor at Boston College’s Connell School of Nursing, “Monitoring symptoms on a spectrum, versus present or not present, with reliable and valid measures may enhance clinical care by identifying more quickly those who may be at risk for poor outcomes, such as lower quality of life, hospitalization or death.
Signs you’re at risk of Valve Disease
Breathlessness is a symptom of heart valve dysfunction, which is a prevalent cause of heart failure. Heart valve issues include narrower or stiffened valves (stenosis), valves that seal improperly (prolapse), valves that enable blood to flow backwards (regurgitation), or improperly produced valves. Heart valves are the leaflet-like structures that regulate blood flow between the heart’s chambers (atresia). People with moderate forms of valve disease may go years without experiencing any symptoms until gradually developing more symptoms resembling those of heart failure. Pulmonary hypertension, or high blood pressure in the lungs, is another complication of valve dysfunction. Aortic stenosis, which happens when the aortic valve narrows and inhibits blood flow from the heart, is one of the most significant and prevalent types of valve disease.
Women with aortic stenosis are more likely than men to have shortness of breath, exercise intolerance, and physical frailty, and they are also more likely to score lower on the New York Heart Association Functional Categorization, a widely used classification system for heart failure. Chest pain is more frequently reported by males with valve disease than by women.
Signs you’re at risk of Stroke
When a blood vessel to the brain is clogged or bursts, it creates a stroke, which often results in recognized symptoms that call for immediate medical attention. The American Stroke Association advises everyone to keep in mind the acronym F.A.S.T. meaning Face drooping, Arm weakness, Speech difficulty, and Time to contact 9-1-1 to recognize stroke symptoms necessitating rapid medical assistance. Confusion, dizziness, loss of balance or coordination, and visual abnormalities are other signs of a stroke. It’s important to recognize the signs of a stroke since receiving treatment right away could lower or eliminate the risk of long-term impairment or death.
In addition to the classic symptoms of a stroke, women are more prone than males to experience other, less common symptoms. These signs include a headache, mental confusion, unconsciousness, or stupor. A stroke may also affect a person’s ability to think clearly, which may affect their capacity to notice emerging or deteriorating symptoms.
Following a stroke, several symptoms may linger and necessitate ongoing care, regardless of whether they require rehabilitation or become disabilities. Checking for anxiety, depression, fatigue, and pain should be part of the post-stroke screening. The majority of complaints of post-stroke pain occur 4-6 months following a stroke, albeit it may take months for this to happen.
Signs you may have Rhythm Issues
Arrhythmias, also known as rhythm disorders, are frequently described as palpitations or the sensation of an aberrant heartbeat that may be irregular, rapid, fluttering, or halting. Other signs and symptoms include weakness, breathlessness, and lightheadedness, all of which are common to other cardiovascular conditions. Less frequently, individuals with heart rhythm problems may experience anxiety, dizziness, fainting or almost fainting, and chest pain.
While men are more likely to have no symptoms, women and younger persons with rhythm abnormalities are more likely to feel palpitations. Older people are more likely to have unusual symptoms or none at all. People of different races and ethnicities have also been reported to exhibit different symptoms. Data show that compared to Hispanic or white individuals, Black adults report having more palpitations, shortness of breath, intolerance to exercise, dizziness, and chest discomfort.
Signs you may have Vein and Artery Disease
By affecting the arteries in the lower limbs, peripheral arterial disease, or PAD, reduces the blood flow to the legs. The characteristic symptom of claudication, which is discomfort in one or both calf muscles that arise when walking and goes away with rest, may emerge in people with PAD or they may not exhibit any symptoms at all. However, rather than calf discomfort, the most typical symptoms of PAD are a pain in various areas of the legs as well as in the foot and toes. Men are more at risk for heart attacks and strokes than women when PAD is present, which is accompanied by symptoms.
According to Jurgens, evaluating the quality of life, activity restrictions, and the psychological effects of the condition are all part of measuring vascular symptoms. However, current measures frequently depend more on the clinician’s assessment than on the patient’s self-reported symptoms and symptom severity.
People with PAD typically experience depression, particularly women, the elderly, and members of various racial and cultural groups. Additionally, those with more severe PAD are more prone to experience depression.
Similar to PAD, peripheral vein disease (PVD) might go unnoticed or cause leg pain. Leg pain and achiness, heaviness or stiffness in the legs, weariness, cramps, restless legs syndrome, and skin irritation are common symptoms associated with the legs. In one study, those under the age of 65 reported pain, heaviness, achiness, and exhaustion more frequently than people over the age of 65. Vein disease symptoms can occasionally appear in the absence of outward symptoms.
Patients with PAD are the ones who tend to have gender variations in vein and artery disease. Women are more likely to experience symptoms elsewhere than in the calf muscle or none at all. Women’s symptoms are also made more difficult by misconceptions that PAD is more common in men or that other common illnesses, including osteoarthritis, have similar symptoms. Women are more prone than males to experience rapid PAD progression and quality of life issues.
Other risk factors that affect symptoms of heart disease
According to statistics from a national survey, people with heart disease experience depression at a rate that is around twice as high as that of healthy individuals (10% vs. 5%). In a 2014 scientific statement, the American Heart Association recommended that depression be taken into account as a risk factor for poorer outcomes following an acute coronary syndrome episode or diagnosis.
The present statement emphasizes that depression and/or anxiety are common among persons who experience chronic chest discomfort, heart failure, stroke survivors, and peripheral artery disease. Additionally, post-stroke cognitive alterations may influence how and if symptoms are felt or noticed. Throughout the course of any cardiovascular disease, the writing group suggests routine evaluations of cognitive function and depression levels since they have a significant impact on a patient’s capacity to recognize symptoms and any changes in their condition.
“Symptom relief is an important part of managing cardiovascular disease,” adds Jurgens. “It is important to recognize that many symptoms vary in occurrence or severity over time, that women and men often experience symptoms differently, and factors such as depression and cognitive function may affect symptom detection and reporting. Monitoring and measuring symptoms with tools that appropriately account for depression and cognitive function may help to improve patient care by identifying more quickly people who may be at higher risk.”
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