Physical Signs and Symptoms That May Indicate Heart Disease

Introduction

Heart disease is the leading cause of death for both men and women in the United States. Over 647,000 Americans die from heart disease each year, accounting for 1 in every 4 deaths. While heart disease can be genetic, there are many risk factors that can increase a person's likelihood of developing cardiovascular problems. High blood pressure, high cholesterol, smoking, obesity, poor diet, physical inactivity, and diabetes are some of the top controllable risk factors. There are also some surprising physical signs that may indicate a person is at risk for heart disease or already has underlying cardiovascular issues.

Skin Changes

The skin is the largest organ in the body and can sometimes provide visual clues about what's going on inside. Certain skin changes or conditions have been linked to heart disease risk. Here are some examples:

Yellowish Skin

A yellowish tint to the skin, especially around the eyes or on the palms of the hands, can signal carotenemia. This condition develops when there are elevated levels of carotene, an orange-red pigment, in the blood. Carotene is found in many fruits and vegetables like carrots, sweet potatoes, and leafy greens. Eating large amounts of these foods causes carotene to build up. While carotenemia is usually harmless, it may be a sign of poor liver function related to excessive alcohol consumption, diabetes, or thyroid conditions. These underlying health issues can increase heart disease risk.

Eruptive Xanthomas

These are small, yellowish bumps that suddenly appear on the skin. They are caused by deposits of fat and cholesterol under the surface. Eruptive xanthomas are most commonly seen in people with familial hypercholesterolemia, a genetic disorder that causes exceptionally high cholesterol levels. Having familial hypercholesterolemia dramatically raises the risk of early heart disease and heart attacks.

Nail Clubbing

Nail clubbing happens when the tips of the fingers or toes enlarge and the nails curve around these digits significantly. It can be a sign of low oxygen in the blood and often occurs with lung disease. Since lung and heart health are closely intertwined, nail clubbing may also indicate chronic heart conditions like congenital heart disease, heart valve abnormalities, or heart failure.

Swelling

Fluid retention is another common outward indicator that something may be wrong with the cardiovascular system. Swelling in the limbs, also called peripheral edema, is often a result of congestive heart failure. This dangerous condition means the heart is too weak to properly pump blood to the body. Blood can back up into the veins of the legs and feet, causing noticeable swelling. Edema can also stem from damaged leg veins or clotting disorders linked to heart disease.

Swelling in the Abdomen or Legs

When swelling from edema occurs in the abdomen, legs, ankles, or feet, it is called peripheral edema. The swelling is often worse in the lower extremities because excess fluid is pulled downward by gravity when sitting or standing. Ankles often appear puffy or swollen. Leg edema may leave an indentation after applying pressure. Lying down and elevating the legs and feet can help reduce swelling.

Swollen Veins

Prominent and distended veins in the legs and feet, sometimes called spider veins, can also signal edema. Swollen veins may appear twisted or rope-like. They are often blue and may stick out quite far from the surface of the skin. While spider veins are not directly caused by heart problems, the underlying edema that stretches veins can be related to poor cardiovascular health.

Skin Color Changes

Skin color changes like paleness, grayness, cyanosis (blue-tinted skin), and flushing can point to circulation issues that may be tied to heart problems. Here's what to look out for:

Pale Skin

Pale or grayish skin that refuses to return to a normal shade can mean an inadequate supply of oxygen-rich blood is reaching tissues and organs. While this may be triggered by lung problems or severe anemia, it can also stem from a weak heart that cannot pump sufficient blood to the body.

Cyanosis

A blue tint to the skin, especially on the fingers, toes, lips, or nail beds signals cyanosis. This condition arises when deoxygenated blood (blood that doesn't contain enough oxygen molecules) circulates through the arteries instead of oxygen-rich blood. It's commonly caused by heart defects present from birth or lung diseases. But it may also be related to heart failure.

Flushed Skin

Flushed or reddish skin on the face and neck can occur when blood vessels near the surface of the skin expand. This may happen with increased body heat, alcohol consumption, hormonal changes, severe allergic reactions, or strong emotions. However, persistent flushing can stem from carotid artery disease as well. The carotid arteries in the neck supply oxygenated blood to the head and brain. Blockages, plaque, or blood clots in these key arteries that reduce blood flow can trigger skin flushing.

Cold Hands and Feet

Do your hands and feet feel uncomfortably cold all the time, even when the temperature isn't frigid? Poor circulation could be the reason. Narrowed blood vessels restrict blood flow to the extremities. Over time, this causes the hands and feet to constantly feel much colder than the rest of the body. While this phenomenon is commonly caused by lifestyle factors like smoking, it can also signal peripheral arterial disease. Peripheral arterial disease stems from fatty plaque buildup in arteries. It raises the risk of heart attack and stroke.

Lack of Blood Flow

When the blood vessels that supply the hands and feet become narrowed due to arterial plaque and clots, the decreased blood flow makes it hard to keep these extremities warm. The heart has to pump stronger in order to push blood through the constricted vessels, which tires the cardiac muscles.

Poor Circulation

Blood carries heat throughout the body in addition to nutrients and oxygen. Hands and feet that seem cold and clammy frequently can mean circulation is impaired. The heart is not pumping blood efficiently to the peripherals. Over time, the lack of warm blood reaching the skin surfaces results in chronically cold hands and feet.

Anemia

Anemia causes a lower red blood cell count and reduced oxygen-carrying capacity. People with anemia produce less body heat. They may often feel chilled and exhibit cold hands and feet. Certain forms of anemia increase the risk of cardiovascular disease.

Enlarged Veins

Prominent, enlarged veins can potentially develop anywhere on the body. However, they tend to be most noticeable on the legs. Bulging leg veins are sometimes called varicose veins. Damaged valves inside the veins cause blood to pool and the vessels to enlarge rather than draining efficiently back to the heart. While this vein disease is often linked to pregnancy, obesity, aging, and genetics, it may also signify underlying heart issues.

Tired Heart

A weak heart that cannot pump blood out of the veins efficiently leads to blood pooling in the legs. The veins stretch over time from the excess pressure and blood volume. A heart weakened by systematic conditions like coronary artery disease may underlie varicose veins.

Right-side Congestive Heart Failure

Enlarged veins in the legs and feet can develop when there is pressure buildup in the vessels due to congestive heart failure (CHF). If the right side of the heart is unable to push blood effectively to the lungs, some blood backs up into the legs and abdominal organs. This is called right-side CHF.

Kidney Damage

High blood pressure associated with heart disease can damage the kidneys over time. Impaired kidneys allow fluid retention in the legs, enlarging the veins. Kidney damage is also tied closely to congestive heart failure risks.

Skin Ulcers

Certain types of skin ulcers or sores that develop on the lower legs and ankles may indicate peripheral artery disease and poor circulation. Diabetics are at especially high risk for these arterial ulcers. Heart disease is more common in those with diabetes, partially due to the vascular effects of prolonged high blood sugar levels.

Poor Wound Healing

Without an adequate blood supply, wounds heal very slowly. Skin ulcers can develop from minor injuries or abrasions. Plaque in the leg arteries limits nourishing blood flow to the area so that wounds cannot heal properly.

Infections

Poor blood circulation prevents white blood cells from efficiently reaching wounds to prevent infection. Bacteria can multiply in the environment of sluggish blood flow, turning a minor lesion into a festering, painful ulcer.

Diabetic Complications

Those with diabetes have higher risks for atherosclerosis where plaque narrows arteries. Impaired sensation from nerve damage also makes diabetics less likely to notice skin injuries before they worsen. These factors make diabetics more prone to non-healing ulcers that can lead to gangrene.

Vision Issues

The blood vessels and nerves to the eyes can also show early evidence of cardiovascular disease. Some key vision changes to know about include:

Mini-strokes

Transient loss of vision or blurred vision in one eye can be caused by a temporary reduction of blood flow. This mini-stroke in the retinal artery is called amaurosis fugax. It's a warning sign for stroke and heart attack as plaque is likely building up in arteries.

Retinal Imaging

Optometrists can take pictures of the tiny blood vessels within the retina during a routine eye exam. Viewing these retinal images can show signs of hypertension, diabetes, high cholesterol, and coronary artery disease before other overt symptoms appear.

Arcus Corneae

A white or gray ring or arc on the cornea of the eye may be a warning of high cholesterol and fatty plaque deposits in the body's arteries early in life. While not dangerous on its own, the arcus corneae indicates cardiovascular risks.

Snoring and Sleep Apnea

Breathing issues during sleep may also act as a red flag for hidden heart problems. Interruptions in oxygenation and breathing rhythms put more strain on the heart.

Fragmented Sleep

Snoring and sleep apnea cause sleep to be frequently disrupted. The fragmented nature of sleep deprives the body of restorative deep sleep and puts stress on the systems. Without sound sleep, insulin sensitivity, hormonal balance, and metabolism are impaired.

Drop in Oxygen

When breathing temporarily stops during sleep from apneas, the blood oxygen level drops. Low oxygenation requires the heart to pump faster and stronger to circulate oxygen successfully to the vital organs.

High Blood Pressure

Sleep apnea is associated with high blood pressure that damages the cardiovascular system over time. The lack of oxygen and awakening from sleep apneas trigger the release of fight-or-flight hormones that elevate blood pressure.

Constipation

Difficulty having bowel movements may seem unrelated to cardiovascular health. However, chronic constipation can be a subtle sign of poor circulation or low heart function.

Low Physical Activity

Sluggish bowels and constipation often accompany lack of exercise and low mobility. Sedentary lifestyles raise risks for obesity, high cholesterol, high blood pressure, and coronary artery disease.

Weakened Muscles

Constipation from loss of muscle tone in the abdomen is tied to congestive heart failure. The strain of constant coughing with CHF weakens abdominal muscles that assist with bowel movements.

Medications

Many common heart medications like diuretics, blood pressure drugs, and calcium channel blockers have constipation as a side effect. The electrolyte imbalances caused by some cardiac drugs impair digestion.

Sudden Heart Rate Changes

A noticeable skipping beat or sudden change in heart rate, up or down, can signal conduction system problems where the heart's electrical pulses misfire. Some examples include:

Bradycardia

This is when the resting heart rate drops below 60 beats per minute. Slow heart rates allow blood to stagnate and pool, increasing clot risks. Bradycardia may be caused by electrolyte imbalances, sleep apnea, heart disease, or certain medications.

Tachycardia

A resting heart rate consistently higher than 100 beats per minute characterizes tachycardia. Rapid heart rates make the heart work too hard. Tachycardia often arises from heart disease, high blood pressure, hyperthyroidism, arrhythmias, or stress.

Palpitations

Fluttering sensations in the chest and feeling the heart suddenly racing or pounding may occur with harmless premature ventricular or atrial contractions. However, palpitations after exercising, with shortness of breath, or in those over 50 warrant medical attention.

Recurrent Pneumonia or Bronchitis

Repeated bouts of respiratory infections like pneumonia and bronchitis can signify certain heart issues. These include:

Congestive Heart Failure

Fluid collects in areas of the body including the lungs with CHF. This fluid congestion breeds bacterial growth, raising risks for pneumonia. The weakened heart cannot efficiently filter bacteria from circulating blood.

Pulmonary Hypertension

High blood pressure stresses the pulmonary arteries and capillaries in the lungs. Pulmonary hypertension reduces immune function in the lungs, increasing susceptibility to pneumonia.

Arrhythmias

Irregular heartbeats allow blood to pool and thicken in the pulmonary blood vessels. Blood clots can develop which harbor infectious bacteria.

Recurrent Dizziness

More than the occasional lightheaded feeling when standing up fast, recurrent spells of dizziness may point to cardiovascular conditions like:

Low Blood Pressure

Blood pressure that runs on the low side reduces blood flow to the brain if it drops too low. Dehydration, medications, or prolonged bed rest can trigger low blood pressure and dizziness.

Stroke Risk

Plaque buildup in the carotid arteries in the neck can lead to mini-strokes and transient ischemic attacks. These interrupt blood to the brain, causing spots of dizziness.

Heart Valve Disorders

Defective or damaged heart valves mean some oxygen-depleted blood flows to the brain at times instead of freshly oxygenated blood. The lack of oxygen triggers dizzy spells.

Swelling and Discomfort in the Legs

Aching, tired, cramping, or heavy legs can be dismissed as nothing serious. But these symptoms may actually indicate peripheral artery disease or blood clots related to a cardiovascular condition.

Atherosclerosis

Plaque buildup from atherosclerosis narrows the peripheral arteries in the legs. Blood struggles to get through these narrowed vessels, causing a sense of fatigue, heaviness, and cramping in the calves or thighs.

Deep Vein Thrombosis

Blood clots in the deep veins, called deep vein thrombosis or DVT, create swelling and pain below the knee or in the calves. Part of the clot can break off and travel to the heart or lungs.

Peripheral Artery Disease

Poor circulation and blocked peripheral arteries equates to inadequate blood and oxygen delivery to the muscles. This causes leg discomfort and locations of radiating pain, especially when walking.

Lifestyle Changes to Lower Risk

Seeing any concerning symptoms? There are many ways to reduce your cardiovascular disease risks through lifestyle adjustments:

Quit smoking

Stop smoking and avoid exposure to secondhand smoke. Smoking is the worst controllable risk factor for heart disease.

Exercise regularly

Get at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise per week. Weight training is great for heart health too.

Maintain a healthy weight

Keep your BMI under 25 and avoid carrying excess weight around the abdominal area. Eat sensible portions.

Reduce stress

Find healthy stress relief outlets like yoga, meditation, journaling, or talking to a friend to manage stress levels.

Eat a balanced diet</

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.