8 Common Heart Problems and When to See a Doctor

8 Common Heart Problems and When to See a Doctor

8 Common Heart Problems and When to See a Doctor 

The heart is a vital organ that works hard to pump blood throughout our body. Most of the time, it does its job without us even thinking about it. But sometimes, the heart can develop problems that cause symptoms that interfere with daily life. Some heart conditions are minor, while others can become serious if left untreated. 

It's important to understand the most common types of heart disease and be aware of any warning signs that indicate it's time to see a physician. Catching issues early can allow for better treatment options before complications set in. Monitoring how you feel and paying attention to your body can help identify subtle changes signaling it’s a good idea to get checked out. 

Coronary Artery Disease 

Coronary artery disease (CAD) is the most common form of heart disease in the United States[1]. It occurs when the major blood vessels that supply the heart with oxygen and nutrients become damaged or diseased. This is usually from the buildup of cholesterol-containing deposits called plaque along the artery walls. As plaque accumulates, the arteries narrow over time, limiting blood flow to the heart muscle. The medical term for this condition is atherosclerosis[1]

The most common symptom of coronary artery disease is angina, which refers to chest pain or discomfort due to insufficient blood flow to the heart tissue[1]. However, some people have a “silent” form of CAD and don’t experience angina or any other symptoms. A heart attack occurs when a plaque deposit ruptures and completely blocks an artery, causing part of the heart to be starved of oxygen[1]. This causes permanent damage to heart muscle unless treated promptly. 

Risk factors for CAD include[1]

  • Family history 
  • High blood pressure 
  • High LDL “bad” cholesterol 
  • Smoking 
  • Diabetes 
  • Obesity 
  • Physical inactivity 
  • Age – risk increases as you get older 
  • Sex – risk is higher in males

Warning signs that it's time to see your doctor include[1]

  • Frequent angina or increasing chest pain 
  • Angina at lower levels of exertion 
  • Unexplained shortness of breath 
  • Palpitations (fluttering heartbeat) 
  • Lightheadedness or dizziness 

Diagnostic tests look for evidence of narrowed arteries and can include[1]

  • EKG and heart monitoring tests 
  • Exercise stress testing 
  • Echocardiogram 
  • Cardiac CT scan 
  • Cardiac catheterization 

Treatments focus on limiting the progression of CAD and improving blood flow to the heart tissue. Options may include[1]

  • Lifestyle changes – improved diet, increased activity, stopping smoking 
  • Medications – aspirin, beta-blockers, statins, nitroglycerin 
  • Medical procedures – angioplasty and stents to widen arteries or coronary bypass surgery in severe cases 

Being attuned to your body and aware of any new symptoms is key to getting appropriate care for coronary artery disease. If you experience chest pain, shortness of breath, extremity pain, or other issues that concern you, make an appointment to see your doctor. 

Heart Attack 

A heart attack, also called a myocardial infarction, happens when blood flow to part of the heart muscle is severely reduced or stopped[2]. This occurs due to a total blockage of the arteries supplying the heart tissue. Heart muscle that's deprived of oxygen begins dying unless the blood supply can be restored promptly. 

The classic sign of a heart attack is central chest pain or discomfort that also can occur in other areas like the arms, jaw, neck, or back[2]. Shortness of breath also may happen. Nausea, lightheadedness, cold sweats, and fatigue are other common symptoms. However, heart attacks can have atypical symptoms too, especially in women. These may include indigestion, anxiety, unusual fatigue, or sleep disturbances[2]

Risk factors include[2]

  • Obesity 
  • Physical inactivity
  • High blood pressure 
  • High cholesterol 
  • Smoking 
  • Diabetes 
  • Family history of heart disease 
  • Age – risk increases at 40 for men and 50 for women 

Warning signs that warrant immediate emergency care include[2]

  • Ongoing chest pain or discomfort 
  • Upper body pain spreading to arms, back, neck, or jaw 
  • Shortness of breath with or without chest discomfort 
  • Breaking out in a cold sweat, nausea, or lightheadedness 

Diagnostic tests look for damaged heart muscle and blockages in the coronary arteries. These may include blood tests for heart enzymes, EKG, echocardiogram, and other heart imaging tests[2]

Treatment focuses on quickly restoring blood flow and saving damaged heart muscle. Emergency procedures such as thrombolytics, cardiac catheterization, balloon angioplasty, and stents may be used. Coronary bypass surgery sometimes is needed for severe blockages. 

Waiting to get care can result in more extensive heart damage, complications, or death. Call 911 immediately if you suspect you or someone else is having a heart attack – every minute counts! Medications and lifestyle changes will be recommended following a heart attack to try preventing future episodes. 

Heart Failure 

Heart failure means the heart muscle has become too weak or stiff to efficiently pump enough blood through the body[3]. It can occur on the left or right side of the heart, or both sides. Heart failure may start suddenly after a heart attack, frequent rapid heart rhythms, infection or other cardiovascular events damage the heart muscle. Or it can progress gradually over time due to high blood pressure, CAD, heart valve problems, or cardiomyopathy gradually weakening the muscles. 

Common symptoms of heart failure include shortness of breath, persistent coughing, wheezing, or fatigue[3]. Fluid retention causing swelling of the feet, ankles, legs, or abdomen also can occur. Other possible signs are lack of appetite, confusion, impaired thinking, and increased heart rate[3]. However, some people have few symptoms in the early stages despite significant underlying problems. 

Risk factors for heart failure include[3]

  • Coronary artery disease
  • High blood pressure 
  • Previous heart attack 
  • Cardiomyopathy 
  • Heart valve problems 
  • Congenital heart defects 
  • Diabetes 
  • Sleep apnea 
  • Being overweight 
  • Excessive alcohol use 
  • Smoking 
  • Family history 

Warning signs that it's time to call your doctor include[3]

  • Shortness of breath or persistent cough 
  • Swelling in feet, legs, ankles or abdomen 
  • Fatigue preventing normal activities 
  • Frequent heart palpitations 
  • Lack of appetite, nausea 
  • Difficulty concentrating or confusion 
  • Waking up breathless at night 

Diagnostic tests assess heart muscle function and look for underlying causes. These may include[3]: 

  • Physical exam listening to heart and lungs 
  • Chest x-ray 
  • EKG and heart monitoring tests 
  • Exercise stress testing 
  • Echocardiogram 
  • Cardiac MRI 
  • Cardiac catheterization 

Treatment involves treating underlying causes and reducing strain on the heart[3]

  • Medications – ACE inhibitors, beta-blockers, diuretics 
  • Implanted devices – pacemakers, defibrillators 
  • Surgery – coronary bypass, heart valves, etc. 
  • Lifestyle changes – diet, activity, stopping smoking 
  • Treatment for contributing conditions 
  • Advanced treatments or heart transplant if conditions are severe 

Seeking prompt medical attention for symptoms of heart failure can optimize outcomes before significant heart damage develops. Ongoing care is needed to monitor progression and adjust treatments over time after diagnosis.

Arrhythmias 

An arrhythmia refers to some type of abnormal heart rhythm. These irregular heartbeats may involve the ventricles beating too quickly (tachycardia), too slowly (bradycardia), or erratically[4]. Some start in abnormal locations. Many last briefly and resolve on their own. But others can persist or recur. 

Many people with arrhythmias experience palpitations described like a racing, fluttering, or pounding feeling in their chest[4]. Dizziness, lightheadedness, or fainting also can happen with certain rhythms. However, some arrhythmias cause few if any symptoms. 

Different arrhythmias have varied warning signs about when to call your doctor right away[4]

  • Atrial fibrillation – Episode lasts more than 48 hours causing palpitations, fatigue, chest pain, lightheadedness, or shortness of breath 
  • Ventricular tachycardia – Skipped beats then a run of abnormally fast beats causing palpitations, dizziness, or fainting 
  • Bradycardia – Noticeably slow heart rate of less than 50 causing fatigue, weakness, fainting, or breathing issues 

Common triggers causing arrhythmias include[4]

  • Heart disease, high blood pressure, CAD 
  • Diabetes 
  • Excessive alcohol, caffeine, or stimulants 
  • Electrolyte imbalances 
  • Some medications, prescriptions, or supplements 
  • Advancing age 
  • Genetics – passed down in families 

Diagnostic tests aid in evaluating the type of arrhythmia, how serious it is, and the best treatment approaches[4]

  • Physical exam and detailed history 
  • Blood tests to assess overall health 
  • Electrocardiogram (EKG) and heart monitoring tests over days or weeks 
  • Echocardiogram or other imaging tests 
  • Treadmill stress testing 
  • Cardiac catheterization if needed 

Treatments vary based on the specific arrhythmia and underlying cause[4]

  • Lifestyle changes – improved diet, more exercise, limiting alcohol and caffeine 
  • Vagal maneuvers to interrupt arrhythmia – splashing face with cold water or coughing
  • Medications to control heart rate or rhythm 
  • Medical procedures like cardioversion to “shock” the heart back into rhythm 
  • Implanted devices like pacemakers or defibrillators 
  • Surgery or catheter ablation destroys small areas causing abnormal rhythms 

Pay attention to any symptoms like palpitations, lightheadedness, or feeling your heart is racing or fluttering unexpectedly. Alert your physician promptly about arrhythmias not resolving promptly or causing you concern. 

Heart Valve Problems 

Heart valves control blood flow as it moves through the heart chambers[5]. These valves open to allow blood to move forward then close tightly to prevent it from flowing backward. If valves become damaged or diseased, they may narrow or leak causing strain on the heart muscle. 

There are four valves in the heart that can develop problems[5]

  • Mitral valve between left atrium and ventricle 
  • Aortic valve between left ventricle and aorta 
  • Tricuspid valve between right atrium and ventricle 
  • Pulmonic valve from right ventricle to pulmonary artery 

Common symptoms associated with faulty heart valves include[5]

  • Fatigue 
  • Shortness of breath – especially with activity 
  • Lightheadedness or fainting 
  • Chest pain or tightness 
  • Fluid retention and swelling 
  • Palpitations or irregular heartbeat 

Causes of heart valve disorders include[5]

  • Rheumatic fever or infection damaging valve tissue 
  • Age-related changes causing stretching, scarring, and calcium deposits 
  • Birth defects resulting in abnormal valve structure 
  • Other heart conditions putting increased strain on valves 

Warning signs to see your doctor promptly include[5]

  • New onset fatigue impacting your normal activity 
  • Shortness of breath that worsens 
  • Fainting or near fainting
  • Irregular heartbeat or palpitations 
  • Chest pain, tightness, or pressure 
  • Swelling in the abdomen, feet, ankles, or legs 

Diagnostic tests check the structure and function of heart valves[5]

  • EKG and heart monitoring tests 
  • Chest x-ray 
  • Echocardiogram 
  • Cardiac MRI 
  • Heart catheterization 

Treatments vary depending on severity and may include[5]

  • Medications to ease strain on heart 
  • Balloon valvuloplasty to widen valve opening 
  • Valve replacement surgery 
  • Heart transplant if severe valve disease 

Stay alert to any new symptoms that could signal heart valve abnormalities. Call your physician if you start having concerning issues or existing problems seem to worsen. 

Heart Murmurs 

A heart murmur refers to an abnormal whooshing or swishing sound during a heartbeat cycle[6]. Murmurs happen due to turbulent blood flow caused by abnormalities in the heart or major blood vessels. 

Heart murmurs sometimes signal underlying problems needing treatment[6]. But they also often are harmless incidental noise of no concern. Distinguishing important murmurs from benign ones involves getting evaluated professionally. 

Many people with murmurs have no obvious symptoms. The abnormal sound is only detected by a physician listening with a stethoscope during a physical exam. However, some concerning murmurs may cause symptoms like[6]

  • Unusual fatigue impacting normal activity 
  • Lightheadedness or fainting 
  • Shortness of breath 
  • Palpitations 
  • Swelling in lower extremities 

Causes differ depending on the type of murmur[6]:

  • Congenital – Present at birth due to abnormal openings between heart chambers or vessels near the heart 

- Often disappear over time or remain harmless lifelong 

  • Valvular – Problem with heart valves not closing tightly causing leakage - Related to valve abnormalities from infection, rheumatic fever, heart conditions putting strain on valves 
  • Other – Increased blood flow volume or pressure speeding flow 

- Caused by anemia, hyperthyroidism, pregnancy, aortic aneurysm 

Warning signs involving more risk with murmurs[6]

  • Systolic murmur – heard between S1 and S2 heart sounds 
  • Diastolic murmur – heard between S2 and next S1 heart sounds 
  • Murmur > Grade 3/6 loudness or length 
  • Associated symptoms like chest pain or swelling 

Diagnostic tests provide more details[6]

  • Physical exam assessing murmur loudness, timing, shape, and location 
  • Patient's health history and risk factor review 
  • Blood tests checking for medical conditions related to murmurs 
  • Chest X-ray evaluating heart size 
  • EKG tests monitoring electrical conduction 
  • Echocardiogram visualizing heart structure and valve function 

Treatments vary greatly based on the murmur cause[6]

  • Most murmurs require no special treatment 
  • Medications easing workload on the heart 
  • Antibiotic prophylaxis prior to certain medical, surgical, or dental procedures
  • Surgery rarely needed for problematic valves or connections 

Discuss with your physician if you have concerns about an existing murmur or have been told you have one. Have them clarify whether additional follow-up, precautions, or treatment are recommended for your specific situation. 

Congestive Heart Failure (CHF) 

Congestive heart failure refers to an inability of the heart to pump adequate blood to meet the body’s demands[7]. This leads to blood “backing up”, causing congestion and fluid accumulating in the lungs or peripheral tissues. CHF may start gradually or occur suddenly following a heart attack or other event weakening the heart muscle. 

Common symptoms of CHF include[7]:

  • Shortness of breath – with activity or even at rest 
  • Persistent cough – worse at night or lying down 
  • Wheezing or difficulty breathing when lying flat 
  • Sudden weight gain due to fluid retention 
  • Abdominal swelling or bloating 
  • Extreme fatigue or weakness 
  • Rapid or irregular heartbeats 

Warning signs requiring prompt medical attention[7]

  • Sudden onset of shortness of breath at rest 
  • Waking up gasping for breath 
  • Chest pain, tightness, or pressure 
  • Blue tinge to lips or nail beds 
  • Feeling exhausted doing normal activities 
  • Fainting or loss of consciousness 

Risk factors making CHF more likely include[7]

  • Coronary artery disease and previous heart attack 
  • Long-standing uncontrolled high blood pressure 
  • Heart valve abnormalities 
  • Cardiomyopathy and heart muscle damage 
  • Congenital heart defects present at birth 
  • Diabetes, obesity, and other medical conditions 

Diagnostic testing to confirm CHF and check severity[7]

  • Medical history review and physical examination 
  • Blood tests assess related conditions and organ function 
  • Chest x-ray shows heart size and fluid buildup 
  • Heart rhythm and monitoring tests 
  • Echocardiogram evaluating heart’s pumping ability 
  • Cardiac catheterization measuring pressures 

Treatments focus on controlling symptoms and managing underlying issues[7]

  • Lifestyle changes – diet, activity, weight management 
  • Diuretics removing excess fluid 
  • ACE inhibitors and beta blockers easing strain on heart 
  • Implantable devices like CRTs if appropriate 
  • Surgery options for some causes like blocked arteries or faulty heart valves 

Don’t delay seeking medical care if you experience chest pressure, difficulty breathing, swelling, fatigue, or other concerning signs that could indicate congestive heart failure. Call 911 about any

symptoms so severe you fear they may be life-threatening. Ongoing follow-up care is crucial after a CHF diagnosis. 

Cardiomyopathy 

Cardiomyopathy refers to diseases of the actual heart muscle that make it difficult for the heart to deliver enough blood to the body[8]. This causes the chambers to excessively stretch or become rigid, limiting their ability to fill or pump normally. 

There are four main types of cardiomyopathy[8]

  • Dilated cardiomyopathy – Heart muscle thins and chambers enlarge 
  • Hypertrophic cardiomyopathy – Heart muscle thickens so chambers don’t fill efficiently 
  • Restrictive cardiomyopathy – Rigid heart muscle prevents adequate filling
  • Arrhythmogenic right ventricular cardiomyopathy – Muscle replaced by scar tissue 

Many people with cardiomyopathy experience vague, common symptoms for some time before diagnosis such as fatigue, shortness of breath, swelling, palpitations, and dizziness. However, it also may cause no warning signs initially and lead to sudden heart failure. 

Risk factors include[8]

  • Family history of cardiomyopathy or sudden cardiac arrest 
  • Viral infections or toxins damaging the heart muscle 
  • High blood pressure or previous heart attack 
  • Heavy alcohol use and illicit drug use 
  • Nutritional deficiencies 

Warning signs requiring prompt physician evaluation[8]

  • Fainting, dizziness or lightheadedness 
  • Shortness of breath with minimal activity 
  • Chest discomfort, tightness or pain 
  • Swelling in the abdomen, legs, or feet 
  • Palpitations or irregular pulse 

Diagnostic testing to confirm cardiomyopathy includes[8]

  • Physical examination listening to heart sounds 
  • Patient and family history review 
  • Blood tests 
  • Chest x-ray 
  • Electrocardiogram 
  • Echocardiogram evaluating pumping ability 
  • Cardiac MRI visualizing heart muscle
  • Heart catheterization measuring pressures 

Treatment focuses on managing symptoms and halting disease progression[8]

  • Medications – Beta blockers, ACE inhibitors, and diuretics to reduce strain on heart and relieve congestion 
  • Implantable cardioverter defibrillator to prevent sudden cardiac arrest if high-risk 
  • Pacemaker if heart rates are very slow 
  • Ventricular assist devices providing mechanical support if heart failure is advanced 
  • For end-stage heart failure, a transplant may be considered 

Lifestyle changes like improved nutrition, activity guidelines, and avoiding toxins also play a role in cardiomyopathy management. Pay attention to any new symptoms involving chest discomfort, breathing issues, fluid retention, or irregular heartbeats. Seek prompt medical attention to uncover cardiomyopathy before complications arise. 

Ongoing monitoring and follow-up care are needed even if symptoms resolve because of cardiomyopathy’s progressive nature. Report any warning signs or symptom changes to ensure treatment adjustments can be made over time to preserve heart function. Being vigilant assists in preventing sudden cardiovascular crises. 

References: 

[1] CDC. “Coronary Artery Disease.” Centers for Disease Control and Prevention, 19 July 2021, www.cdc.gov/heartdisease/coronary_ad.htm

[2] CDC. “Heart Attack Symptoms, Risk, and Recovery.” Centers for Disease Control and Prevention, 12 July 2022, www.cdc.gov/heartdisease/heart_attack.htm

[3] “What Is Heart Failure?” NHLBI, NIH, 24 Mar. 2022, www.nhlbi.nih.gov/health/heart-failure. [4] “What Is an Arrhythmia?” NHLBI, NIH, 24 Mar. 2022, www.nhlbi.nih.gov/health/arrhythmias

[5] “What Are Heart Valve Diseases?” NHLBI, NIH, 24 Mar. 2022, 
www.nhlbi.nih.gov/health/heart-valve-diseases

[6] “Heart Murmurs: MedlinePlus Medical Encyclopedia.” Medlineplus.gov, 2022, medlineplus.gov/ency/article/003266.htm

[7] Malik, Ahmad, et al. “Congestive Heart Failure.” Nih.gov, StatPearls Publishing, 5 Nov. 2023, www.ncbi.nlm.nih.gov/books/NBK430873/

[8] “What Is Cardiomyopathy?” NHLBI, NIH, 19 Apr. 2022, 
www.nhlbi.nih.gov/health/cardiomyopathy.

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