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Can You Miss the Signs of Heart Disease or a Heart Attack?

Q. What are symptoms of heart disease? Can you tell if you have heart disease without having tests done?

A. The classic warning signs of heart disease and heart attacks are chest pain, often described as a feeling of pressure or a tight band around the chest, and shortness of breath during physical exertion that subsides when you’re at rest, said Dr. Suzanne Steinbaum, a spokeswoman for the American Heart Association. But symptoms may be more subtle. If you find yourself suddenly struggling to carry out normal daily activities, breaking out in a sweat, or becoming nauseated when walking or going upstairs, she said, “the first thing you should think of is your heart.” Call 911 and seek medical care immediately; you could be having a heart attack, the first symptom of heart disease for many.

“The one who knows your body best is you, and the more you keep track of how you feel, the better off you are,” Dr. Steinbaum said. “The one message I try to get across to people is to get checked out if they’re having any symptoms. If you’re wrong, it’s fine — so what? But if you’re right and you don’t go, you could die.”

Other symptoms to pay attention to include pain in the neck, jaw, back or shoulders; vomiting or gastrointestinal symptoms; swelling in the ankles, legs and feet, which can be an indication of heart failure; and heart palpitations or a fluttering in your chest, which may indicate an abnormal heartbeat or arrhythmia and be accompanied by lightheadedness, dizziness or near fainting.

Some people may experience atypical symptoms like sweating, nausea or even flulike symptoms rather than classic chest-clutching pain, Dr. Steinbaum said. Rosie O’Donnell, the talk show host, experienced such unusual symptoms during her 2012 heart attack – which she has described as “hot, exhausted, pain, pale, puke,” or HEPPP — that she didn’t seek medical attention until the next day.

Even if you have no family history of cardiovascular disease, you may be at risk because of advancing age, smoking, lack of exercise, poor diet, chronic conditions like diabetes, stress and anxiety or depression, social isolation or excess body weight, particularly abdominal fat, Dr. Steinbaum said.

A visit to the doctor for tests will tell if you have specific risk factors for heart disease like high blood pressure or high cholesterol, which can be treated with medications, dietary changes and other measures. “The more honest you are about the lifestyle you have, the better your chances of preventing something from happening,” Dr. Steinbaum said.

Do you have a health question? Ask Well.

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