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Heart issues are often associated with older age or sudden health emergencies, but in some instances your heart might be giving you gentle warnings well before things become serious. In the rush of everyday life, it's easy to dismiss tiredness or mild discomfort, but these seemingly minor inconveniences could be signs that your heart needs attention.
With World Heart Day (September 29) approaching, we spoke to Dr Oliver Guttmann, consultant cardiologist at The Wellington Hospital, part of HCA Healthcare UK, who shared four subtle signs that could indicate it's time for a heart check-up.
1. Chest pain or discomfort
"Chest pain is the most recognised warning sign of heart problems, but it rarely feels like the dramatic 'crushing' pain seen in films," clarifies Guttmann. "It can be subtle, misleading or intermittent."
The cardiologist explains that it is more likely to feel like pressure, heaviness, or tightness across the chest.
"It is sometimes described as a band squeezing the chest," says Guttmann. "People also may experience a burning or aching sensation that resembles heartburn or indigestion and/or pain radiating to the arms (often the left), shoulders, neck, jaw, or back.
"In daily life you might feel a squeezing sensation when hurrying to catch a train which eases after sitting down, or experience a dull ache across the chest while climbing stairs at work."
These symptoms may indicate angina, caused by reduced blood flow to the heart, explains the cardiologist.
"While angina itself is not a heart attack, it signals underlying coronary artery disease and increases the risk of a heart attack if untreated," says Guttmann. "Accompanying symptoms may include nausea, sweating, dizziness, or a sense of anxiety, which are all signs that the heart is under strain."
2. Shortness of breath
"Being slightly breathless after vigorous exercise is normal. However, shortness of breath during routine activities may indicate that the heart is struggling to pump blood efficiently," explains Guttmann.
The cardiologist says some warning signs to watch out for include feeling unable to take a full deep breath while sitting still, needing extra pillows to sleep comfortably at night and waking suddenly gasping for air, sometimes accompanied by coughing or wheezing.
"Also look out for breathlessness that worsens over days or weeks, or that limits simple tasks," he adds.
Shortness of breath can manifest in several different ways in daily life.
"For example, struggling to climb a single flight of stairs that used to be easy, feeling winded when walking across a room carrying laundry or a sudden breathlessness while bending down to tie your shoes," lists Guttmann.
This can occur when fluid backs up into the lungs, a condition often associated with heart failure, he explains.
"Even mild or intermittent symptoms should prompt a medical review, as early detection can prevent serious complications," says Guttmann.
3. Fatigue or weakness
"Everyone gets tired occasionally, but heart-related fatigue is persistent, extreme, and not relieved by rest," says Guttmann.
"Warning signs include feeling exhausted after simple household chores like vacuuming or washing dishes, needing frequent naps during the day, a sudden weakness that makes routine tasks like carrying groceries difficult, and difficulty concentrating or performing mental tasks due to low energy."
In everyday life this could be feeling completely drained after walking a short distance from the car to the shop, or being unable to complete a normal exercise routine without extreme fatigue, he explains.
"This can occur because the heart is not pumping enough oxygen-rich blood to the muscles and organs," says Guttmann. "Women may notice unusual fatigue as one of the earliest signs of heart disease, often without the classic symptom of chest pain."
4. Irregular heartbeat
"A heartbeat does not have to be perfectly regular, but frequent palpitations or irregularities should not be ignored," says Guttmann. "Signs to watch out for include fluttering or "skipping" sensations in the chest and sudden pounding or racing heartbeats even at rest.
"Also, look out for feeling your heart "flip" or "thump" unexpectedly or episodes that last from a few seconds to several minutes and may occur multiple times a day."
Examples in daily life may include noticing a fluttering sensation while reading or sitting quietly, or skipped beats causing momentary dizziness or lightheadedness, says the cardiologist.
"These symptoms can indicate arrhythmias, such as atrial fibrillation, which increases the risk of stroke and heart failure," explains Guttmann. "Some irregularities are harmless, but persistent or severe episodes should be evaluated with an ECG or other heart-monitoring tests.
"Regular check-ups, lifestyle management, and awareness of subtle symptoms are essential for maintaining heart health. Early recognition and treatment of heart problems can save lives."