March 11, 2022
Heart disease is the leading cause of death in the United States, claiming the lives of approximately 659,000 Americans each year and impairing the quality of life of many others who manage a range of conditions.
The sheer prevalence of cardiovascular health issues means that many people may be developing them or already have a heart problem and should receive medical attention.
A wide range of heart conditions can occur in people of all ages, but cardiovascular disease most commonly affects people age 50 and older.
Your heart might be giving you day-to-day signs that it's time to see a doctor to figure out whether an issue exists and what type of treatment is most appropriate.
Ashwani Gupta, MD is a Trinity Health Mid-Atlantic cardiologist who treats patients at Nazareth Hospital in Philadelphia, as well as St. Mary Medical Center in Langhorne and Mercy Fitzgerald Hospital in Darby. Gupta specializes in electrophysiology and primarily deals with arrhythmias, or conditions involving an irregular heart rate.
"Sometimes people feel their heart going too slow, or they feel their heart going too fast, but 50 percent of the time, they don't feel anything unusual," Gupta said. "What they feel is being tired and having a lack of energy."
If you often feel especially exhausted or experience shortness of breath after physical exertion, it could be a sign of a heart rhythm problem.
Slow Heart Rate
A slow heart rate, known as bradycardia, commonly includes symptoms such as chest pain, confusion, memory problems, dizziness and lightheadedness. Bradycardia can be caused by damage to heart tissues and be influenced by family history, but it can also occur for reasons unrelated to an underlying disease. Bradycardia is typically characterized by a heart rate of less than 60 beats per minute.
Sometimes, lifestyle changes are all that's needed to help a patient’s heart rate to return to a more normal range. Otherwise, the best available treatment is a pacemaker, a small device implanted in the chest to generate electrical impulses and regulate how the heart pumps blood.
Fast Heart Rate
A fast heart rate, known as tachycardia, can have a wide range of causes that may or may not be a sign of a problem. In addition to older patients, tachycardia often affects young people who may have palpitations or the sensation of the heart skipping and flip-flopping.
Young people with an arrhythmia may get misdiagnosed and placed on anxiety medications, sometimes for long periods, before an underlying heart problem is identified as the cause.
"We usually recommend putting a monitor on patients experiencing these symptoms to make sure that this is not a heart arrhythmia," Gupta said. "If we find that it is, we can either treat it with medication or we can do an ablation procedure that will cure them and prevent [the need] to take medicine."
Tachycardia is a heart rate of more than 100 beats per minute.
The most common heart rhythm disorder is atrial fibrillation, or A-fib, a quivering heartbeat that can lead to blood clots and potentially a stroke. People with A-fib may experience chest pain, dizziness, fatigue and trouble exercising, in addition to shortness of breath.
Patients diagnosed with A-fib should expect to go on a blood thinner to prevent a stroke, in addition to other medications to help manage their heart rhythm.
"We can completely reduce the risk of stroke and have these patients functioning normally," Gupta said. "They usually have a very good prognosis."
The best way to reduce the risk of developing an arrhythmia is to exercise, have a low body mass index (BMI) and avoid smoking and excessive alcohol consumption.
"In the older population, being overweight is a major risk for arrhythmias," Gupta said. "If a patient is able to lose weight, we can usually get the condition under control."
People who have high a BMI should get tested for sleep apnea, which puts a significant amount of stress on the heart. This increases the risk of developing high blood pressure, congestive heart failure and heart attack.
It's a good idea for people over 40 to get their cholesterol levels checked at least once every five years; however, people at high risk for heart disease should get it checked more often. A medication or lifestyle change may be required to reduce the risk of having a heart attack.
"The problem with heart attacks is that [patients may not] get the typical symptom of chest pain," Gupta said. "If patients do have some uneasiness or burning in the chest that worsens with exertion and improves with rest, it should be evaluated to figure out whether it is due to heart blockage."
One alarming symptom to watch for is syncope, or episodes of passing out.
"If you're passing out for no reason, you should definitely see a cardiologist," Gupta said. "It could be as simple as being dehydrated, or a benign condition such as vasovagal syncope, but it may also indicate a significant heart problem."
Congestive Heart Failure
Congestive heart failure, another common condition, occurs when the heart doesn't pump blood as efficiently as it should, leading to chronic symptoms.
"Congestive heart failure usually presents itself with swelling in the leg. If you're older than 50 and have this symptom, don't dismiss the issue," Gupta said. "The same thing goes with pain in the leg, especially in people who smoke. They can develop blockages in the leg arteries."
If you regularly experience any of these symptoms or a have a family history of heart disease, it is always best to be proactive and seek an evaluation and follow-up care.