9 Sneaky Signs of Heart Disease Doctors Say Women Over 50 Too Often Dismiss
Many of us write off symptoms like headaches, sleep apnea and jaw pain as just minor bothers
When you think about cardiovascular disease, symptoms like chest pain and shortness of breath likely leap to mind. But what are the sneaky, under-the-radar warning signs of heart disease in women that are easy to miss? We spoke to top cardiologists to learn about the subtler—but no less important—symptoms we need to watch out for to safeguard our heart health.
What is heart disease?
Heart disease is an umbrella term encompassing several conditions including coronary artery disease (CAD), irregular heartbeats and problems affecting the heart valves or muscles.
Another, less technical, way to describe it: “We define heart disease by a person who has had a heart attack, stroke or had a stent or bypass surgery,” says cardiologist and women’s health advocate Suzanne Steinbaum, MD, founder and CEO of Adesso, a med-tech company that empowers women to live healthy and vital lives.
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“In other words, we [traditionally] define heart disease as the state of sickness,” she continues, explaining that the way she sees it, this is too backward-looking and doesn’t focus enough on prevention: “I prefer to define heart disease by the main risk factors, because if you have them, it’s time to become conscious of what you need to do to actually prevent getting sick.”
Those risk factors include:
- High blood pressure
- High cholesterol
- Elevated blood sugar (whether due to metabolic syndrome or diabetes)
- Being overweight or obese
- Smoking
- Poor diet (high in processed foods, sugar and saturated fats)
- Lack of regular physical activity
- Poor sleep quality
9 sneaky signs of heart disease in women
While prevention (managing the risk factors above) is the best medicine, heart disease is treatable, and in some cases, even reversible. You already know that chest pain is a common symptom. Here, a few sneakier signs of heart disease:
Heart palpitations
“A symptom that is often disregarded is frequent palpitations with or without dizziness, which can be due to an abnormal heart rhythm,” says cardiologist Meghana Rao Brito, MD, Assistant Professor of Medicine at Yale School of Medicine, who specializes in cardiovascular disease in women and cardiovascular imaging.
Indeed, heart palpitations are sneaky for a reason: “They’re a really common symptom of perimenopause and menopause,” adds Dr. Steinbaum, explaining that declining estrogen and progesterone levels can affect the electrical signals in the heart. “So palpitations could mean nothing—or they could mean something. It’s worth getting checked out by your doctor.”
Chronic headaches
High blood pressure can trigger headaches, which is why severe headaches can be a sign of heart disease, especially in women. “If you have chronic migraines or experience visual changes, that’s a sign to see your doctor,” she says. Indeed, a study in JAMA found that women who experienced chronic migraines, especially with aura, had an increased risk of heart disease.
Sleep apnea
“Sleep apnea is one of the biggest issues that leads to all types of heart disease, such as coronary artery disease, heart attack, stroke or atrial fibrillation,” she says. That’s because sleep is so fundamental to our overall health. “Our cells need restoration, and that process happens with sleep—it’s a recovery period.” But when we don’t get those restorative Zzzs, inflammation ticks up, increasing the risk of heart disease.
Coughing and swollen ankles
A buildup of fluid in the ankles, legs or abdomen is another symptom, says Dr. Rao Brito. “Difficulty breathing or coughing while lying flat can also be a sign of fluid buildup in the setting of a weak heart muscle.”
What’s more, research in The American Journal of Medicine shows that chronic lung infections can weaken the heart, leading to heart disease.
Flu-like symptoms
Nausea, vomiting and flu-like symptoms can also be stealthy signs of heart disease, Dr. Steinbaum says, adding: “These symptoms are more common in women than in men. I also think that women tend to put themselves last and are used to being uncomfortable every month for years, so we just have a stronger pain threshold. And this can work against us because we’re more reluctant to seek treatment.”
Less exercise tolerance
One important sign of heart disease is a decline in exercise tolerance, says Judith Goldfinger, MD, FACC, a clinical cardiologist and Director of Vascular Medicine at Mount Sinai West. “Patients may say something like, ‘I used to be able to do this [like climb the stairs] easily, but now I can’t.” That can be a key clue.
Patients often deny classic heart disease symptoms like chest pain or shortness of breath, but they notice a general reduction in what they’re able to do physically, she adds.
Nausea or indigestion
These symptoms can occur when heart disease affects the arteries on the bottom portion of the heart, explains Dr. Goldfinger.
Jaw pain
“Sometimes patients go to the dentist first because they think it’s a dental problem,” Dr. Goldfinger notes. “I’ve had dentists send patients to me saying, ‘This jaw pain isn’t dental—you should evaluate their heart.’” In fact, dental health and heart health are so closely linked that more and more dentists are now checking patients’ blood pressure,” she adds.
If you experience unexplained jaw pain, especially if it comes and goes or worsens with activity, mention it to both your dentist and your doctor.
Leg circulation issues
Many people with leg circulation problems—like restless leg syndrome, that uncomfortable urge to move your legs at night, or leg cramping during walks—don’t realize their symptoms may be heart-related, reveals Dr. Goldfinger.”
“They’ll often say, ‘I have a leg problem, not a heart problem,’ she says. “But it’s the same underlying process [like poor circulation] and the same risk factors.”
The bottom line on sneaky signs of heart disease
If you’re experiencing any of the above symptoms, err on the side of caution and consult a physician. “It is far too common to see women who delay going to the doctor because they are too busy or have too many people depending on them,” says Dr. Rao Brito.
“In addition, I see so many women who have complained about symptoms to multiple health care professionals, only to be told that their symptoms are due to anxiety,” she adds. “I cannot stress the importance of advocating for yourself and making sure your symptoms are recognized and that your concerns are heard.”
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