11 signs you might have heart disease

Will that pain wear off, or is it time to see your doctor or even call an ambulance? BHF Professor David Newby highlights the 11 symptoms that you need to take seriously.

Around 11 per cent of men and nine per cent of women in the UK have been diagnosed with some form of heart or circulatory disease. But what symptoms can we look out for that might indicate a potential heart problem? David Newby, BHF John Wheatley Professor of Cardiology at the BHF Centre of Research Excellence at the University of Edinburgh, tells us more about 11 signs that could mean it’s time to see a doctor.

1. Chest pain
It’s the classic sign of a heart attack, yet many people don’t realise this could be a medical emergency. 

Professor Newby says: “If you have chest pain and you feel extremely unwell, you should dial 999 and get an ambulance as soon as possible. If it’s a heart attack, it’s usually described as a heaviness, tightness or pressure in the chest; people will often describe it as ‘an elephant sat on my chest’ or ‘it felt like a tight band around my chest,’ that sort of constricting feeling. 

“If chest pains occur when you are exerting yourself, but go away when you stop, that would suggest it’s more likely to be angina. That would still mean you should go and see a doctor, but you don’t have to call 999.” 

Professor Newby advises that chest pains accompanied by feeling extremely unwell, mean it is probably the right time to call 999 and request an ambulance.

2. Feeling sick

Obviously not every bout of nausea equals a heart attack – but if you’re getting pain as well, alarm bells should ring. Professor Newby says: “If you experience intense chest pain even when you are just sitting around doing nothing and you are also feeling sick, that is the time to call for an ambulance.”  

If you’re getting some discomfort, but not intense pain, as well as feeling sick, call NHS 111 for advice.

3. Stomach pain

Professor Newby says: “Because the heart, the gullet [the passage between your mouth and stomach] and the stomach are all lying right next to each other, the challenge, for both members of the public and doctors, is that a burning or indigestion-type pain and heart pain can be difficult to disentangle. You could call NHS 111 for advice – they have certain algorithms they apply, but they aren’t perfect as there are no hard and fast rules that apply to everyone.”

4. Feeling sweaty

Working up a sweat when you’ve been to the gym or because it’s a really hot day, is nothing to worry about. But feeling hot and clammy along with chest pains is a sign that you should call an ambulance.

5. Leg pain

Professor Newby says: “If you get a gripping, cramping sensation in your calves when you are walking, it might be worth seeing your doctor, as that can be a marker of PAD (peripheral arterial disease). It’s most common in smokers and people who have diabetes.” Make an appointment with your GP. 

6. Arm pain

You might not associate arm pain with your heart, but it can be a sign of a heart attack. Professor Newby says: “If your pain is going down the arm, especially the left arm, or into the neck that makes it more likely to be heart-related than indigestion. If it doesn’t go away, or if you know you have heart disease and have used your GTN (glyceryl trinitrate) spray two or three times to no discernible effect, you should be seeking emergency medical advice.” Call 999 for an ambulance.

7. Jaw or back pain

Professor Newby says: “With heart attacks, it can even happen that the pain is felt in the jaw, or the back. Again, if it doesn’t go away, call 999 and ask for an ambulance.” There is some evidence that women’s symptoms are more likely to vary from ‘classic’ chest pain, and we know that women are less likely to seek medical attention and treatment.

8. Choking sensation

Professor Newby says: “The word ‘angina’ actually means ‘choking’, and sometimes the tightness or pain can be up in the throat. People tend to describe a ‘restricting’ or ‘choking’ sensation.” If the feeling continues, and you haven’t previously been diagnosed with heart problem, you should call NHS 111 – but if you have some of the other signs listed here as well, it might be safer to call an ambulance.

9. Swollen ankles

Professor Newby says: “This shouldn’t be ignored, especially if the ankles get really big, as it can be a marker of heart failure, but it is also very common and has lots of other causes. It could just as easily be from tablets you are taking – for example, blood pressure medication can lead to swollen ankles.”

If you’re getting swollen ankles, it’s worth making an appointment with your GP.

10. Extreme fatigue

Feeling tired all the time can be a symptom of heart failure, as well as of other conditions. Professor Newby says: “Many of my patients tell me they’re tired, whether they’ve got heart failure or not, whether they’ve got angina or not! It’s a difficult one, because it’s so non-specific.”

If you’re tired and you’ve been working long hours or staying up late, it’s probably not your heart – but if you start experiencing extreme tiredness and your lifestyle hasn’t changed, it’s a good idea to chat to your GP.

11. Irregular heartbeat 
Professor Newby says: “This is a hot topic at the moment, there’s a lot of focus on diagnosing irregular heartbeats. I did an audit of the heart monitors we give out to people for investigation and from about 700 people, we found only about 20 that had atrial fibrillation [which can increase your risk of stroke]. The vast majority of people just had extra ectopic beats, which are usually harmless.
“I would suggest that a jumped heartbeat is usually benign and nothing to get too concerned by. Being aware of your own heartbeat is really quite common and in itself nothing to get anxious about.
“If your heart is going very fast and jumping around erratically then that’s when you should see your GP. If you feel like this and then you experience blackouts, call an ambulance.”