6 Silent Signs of Heart Disease You Shouldn’t Ignore 

Chest pain or pressure, shortness of breath and reduced stamina are some of the classic symptoms of heart disease and heart attack and should have you seeking care right away. But they’re not the only signs of heart disease. And because heart disease is the top killer of adults in the U.S., it’s crucial to know the silent signs of the condition and take steps to treat it.

“People may outwardly appear or even feel fine,” says Kaartiga Sivanesan, M.D., MBA, a preventive cardiologist with Sutter, “but they may have significant underlying cardiac risk.”

Here, she shares some of the silent heart disease symptoms to watch for. 

1. Blood Markers

If you’re getting routine preventive care, your provider is probably checking your blood pressure, cholesterol and blood glucose levels. Other, lesser-known markers, including lipoprotein(a) and ApoB, can also signal heart disease risk.

“Lipoprotein(a) is a genetic marker of cardiovascular disease. It’s thought to be present in 1 of 5 people,” Sivanesan says.

ApoB is a protein that forms the “bad” type of cholesterol.

What to do: If you have a family history of early heart disease, such as a first-degree relative with a heart attack before age 55 (male) or 65 (female), talk to your provider about blood tests for lipoprotein(a) and ApoB. 

2. Eye Issues

“The eye can be the first window into what’s going on inside the body,” Sivanesan says. If your optometrist sees changes in the blood vessels in your eyes, that could be a sign of blood pressure issues, especially if you’re young and not seeing your doctor regularly.

What to do: If your eye doctor mentions any concerns about your blood vessels, be sure to follow up with your primary care provider. 

3. Changes in Your Workout Routine

 If you exercise regularly and notice changes in your pace or the effort needed to maintain your usual activity level, it could signal a heart problem.

What to do: Mention it to your doctor. Lots of factors can affect your stamina, and your provider can ask you questions and decide if you need testing, such as a stress test. 

4. Arrhythmia

You may not know if you have atrial fibrillation or another type of electrical disturbance in your heart, but these conditions increase your risk of heart disease.

What to do: Talk to your provider if you notice any fluttering feelings or irregular heartbeats. Your provider can help determine if you have an arrhythmia.  

5. Women’s Health Issues

Just as heart attack symptoms in men and women can be different, heart disease risk factors can vary as well.

“At different stages of a woman’s life, there are factors that can impact cardiovascular risk,” Sivanesan says. Some examples include:

• Polycystic ovarian syndrome (PCOS)
• Preeclampsia during pregnancy
• Early menopause

What to do: Make your primary care provider aware of all your health issues — even those being treated with a different provider — so they can be aware of changes in your risk. Ask for a referral to a cardiologist if necessary.

6. Inflammatory Diseases

Autoimmune and rheumatologic diseases, including lupus, rheumatoid arthritis and psoriasis, may be linked with heart disease.  

What to do: Be sure your medical records are accurate and up to date, so your providers know about factors that could raise your risk.

Don’t Make Assumptions About Your Heart Health

You may think because you’re young or you have healthy habits, you’re not at risk for heart disease. But factors that are outside of your control add to your risk, too.  

“People can be marathon runners, vegan or otherwise healthy, yet they can still be at risk for  heart disease, plaque deposits and early heart attacks,” Sivanesan says.