Heart disease is often thought of as a disease of the elderly and middle-aged, as well as those who are obese. But while the average person is diagnosed in their 60s, doctors say the warning signs can present decades in advance.
The symptoms may begin as subtle, however, which raises the chance of them being missed or dismissed.
Common problems like anxiety, fatigue and limb pain could actually be a sign of a deeper lying issue, according to Dr Dheepak Bhatt, a cardiologist at Mount Sinai.
These signs will be innocuous for a vast majority of people, but if a person feels them alongside chest tightening or has a family history of heart disease then they may want to seek medical attention.
He said behaviors such as stopping smoking or vaping, being more active, eating a healthier diet and even avoiding marijuana can reduce a young person’s risk of heart disease.
The condition is the leading killer of Americans. It is responsible for around 700,000 deaths each year.
An estimated eight percent of American men and four percent of women suffer from the condition.
While everyone feels a little anxious, in some cases, that feeling of uneasiness you’re carrying around could be a sign of a heart issue.
Anxiety and heart disease have a symbiotic relationship with one another. Being constantly on edge stresses out the body, damaging the heart over time.
A person suffering from heart disease is more likely to suffer anxiety too.
‘It’s hard to know which came first. It’s a chicken or egg situation,’ Dr Bhatt says.
Issues with a person’s heart such as palpitations, an irregular heartbeat or just general pain, induce stress in people, leading to anxiety.
In turn, this makes a person’s symptoms of heart disease even worse.
A 2015 study by researchers at Harvard University found that people with anxiety that suffered from coronary artery disease (CAD) were more likely to die.
Their risk increased by a staggering 21 percent.
The anxiety’s effect on the heart is not the only factor at play, though.
People suffering from the mental health condition are less likely to seek out medical attention and more likely to eat diets high in cholesterol, experts say.
As a result, their symptoms are not being treated and even being made worse by their daily food intake.
It is believed that one-in-five US adults suffer from anxiety each year – though many are undiagnosed or do not receive treatment for the condition.
Anxiety sufferers in the US are more likely to be younger – with it most prevalent in under-45s – and female.
While it might be hard to imagine that pain in your legs means anything about your heart, a tingly feeling on your limbs could signal deeper problems.
Numbness, pain and tingling of the legs could be a sign that not enough blood is circulating into the body’s extremities.
Known as Peripheral arterial disease (PAD), the condition occurs when arteries in the legs become narrow and blocked by the build-up of plaque.
This can happen for a variety of reasons, such as poor diets high in sodium or cholesterol, too much stress, smoking or obesity.
There are five arteries in a person’s legs and each play a crucial role in circulating blood to the body’s furthest regions and then back to the heart.
In the thigh, a person has their femoral and popliteal arteries. The anterior tibial, posterior tibial and peroneal arteries are all located in the lower leg, around the shins and calves.
When these arteries get clogged – preventing enough blood from flowing to the lower regions of the body – the tissue is damaged.
In most severe cases, obstructed flow of blood could lead to amputation. The American Heart Association warns 54 percent of amputations in the US are related to PAD.
This symptom is often overlooked, Dr Bhatt says. Leg pain could be a product of being out-of-shape or injury, and rarely will physicians even make the link between the legs and heart disease.
‘Even doctors don’t think about it,’ he said.
If a person suffers pain, numbness or tingling in the legs while walking, and then it suddenly stops when they take a moment of rest, Dr Bhatt says it could be time to go to the doctor.
These could also be signs of a heart attack or stroke, Dr Bhatt explains.
‘Numbness or weakness of an arm or leg could be a symptom of a stroke,’ he said.
People suffering heart attacks may also first feel pain in their arm – usually the left arm – along with tightness in their chest.
Another link many people may not instinctively make is suffering stomach and digestive pains.
People suffering from heart disease will often have sudden, and short-lasting stomach pain at first. As their cardiovascular condition worsens, their gastrointestinal issues will occur more often.
Sudden and sharp pain will occur, usually in the upper right portion of a person’s stomach.
This could be caused by intestinal angina, which occurs when not enough blood reaches the colon.
People suffering from the condition will often experience pain within an hour after eating a meal. On top of the sharp pain, they could also suffer diarrhea, nausea and vomiting.
Many who suffer from intestinal angina will also experience significant weight loss over time, as they will instinctively eat smaller and less meals to avoid the pain.
Restricted blood flow can also be caused by clotting in the stomach’s arteries.
Called intestinal ischemia, the clotting can significantly reduce blood flow into a person’s small intestine.
These clots will often form as result of an irregular or rapid heartbeat. On top of stomach pain, it can also lead to a stroke.
Both of these conditions may first appear as nausea, before escalating into the more severe, noticable, symptoms.
Some people, and maybe even doctors, could write off the problems as heart burn or another digestive issue, not realizing it is actually a serious heart condition.
Dr Dheepak Bhatt, a cardiologist at Mount Sinai, warned that many young people may make the fatal mistake of overlooking early signs of heart issues
While everyone feels tired sometimes, intense fatigue could be a sign there is a problem with your heart.
‘Fatigue is a tough one,’ Dr Bhatt said.
‘It’s a very non-specific symptoms. Most fatigue is not due to heart disease, maybe just a bad night’s sleep.’
But, he explains, when the blood cannot circulate enough blood to vital organs, a person will feel tired.
‘If the heart’s not pumping effectively, that blood and oxygen is not getting to vital organs,’ he continued.
This can cause a host of issues. Not enough blood reaching the lungs can lead to their failure to pull in enough oxygen.
When the kidney does not receive enough blood it will have trouble removing waste products from the body.
If enough blood does not reach the liver, tissue cells in the organ will start to die and the organ could fail.
One of the earliest signs of each of these is fatigue. While being tired on any given day could be caused by a multitude of issues, doctors do advise people suffering from chronic fatigue to seek out medical attention.
Profuse sweating is a bizarre yet common symptom of heart issues.
People suffering from cardiovascular disease will often sweat as a result of their body having to work harder to pump blood.
The sweating also keeps the body’s temperature down, reducing the workload of the heart.
Sweating also removes excess fluids from the body, which reduces the workload of the kidneys in cleaning fluids in the body.
If the kidneys are having trouble performing their duties because of heart failure, then sweating can help keep the vital organs afloat.
Dr Bhatt also says it could the body realizing that it is suffering from some issue, and trying to figure it out.
‘[It could be] the brain and various aspects of the nervous system firing circuits because it knows that something is wrong,’ he explained.
He also said that sudden profuse sweating, especially when a person is not taking part in physical activity, could be one of the first signs of a heart attack.