Toothache Lumpy hands Bald spot Signs you've got a dicky heart
23:17 GMT, 1 October 2012
A heart attack is the most obvious sign your heart’s in trouble, but there are other, discreet symptoms of cardiovascular problems, as leading experts tell ANNA HODGEKISS.
TOOTHACHE WHEN WALKING
Angina can manifest itself in many parts of the body, such as in the teeth
The classic sign of heart disease is angina — pain in the chest caused by narrowed arteries that limit the heart’s blood and oxygen supply.
But angina can manifest itself in many other parts of the body, such as the neck, jaws, arm, between the shoulder blades or in the teeth, says Dr Klaus Witte, a cardiologist at Leeds General Infirmary and senior lecturer at the University of Leeds.
‘A classic but often missed sign of heart trouble is recurrent toothache that strikes only upon exertion such as walking, especially up a hill, and subsides upon rest,’ he says.
Dr David Lindsay, a cardiologist and spokesperson for charity Heart UK, adds: ‘The nerves coming from the heart that transmit the pain of angina may cross over with nerves from elsewhere.’
Indeed, jaw ache is increasingly being recognised as a symptom that can strike weeks before a heart attack.
The pain may feel like it’s radiating outward from the teeth or along the jaw, or can even feel like earache, says Dr Lindsay.
Women who experience migraines with visual disturbance (such as zigzags) at least once a month are twice as likely to develop heart disease, according to a study published by the American Academy of Neurology.
The researchers suggest this may be because the circulation irregularities that cause the severe headaches may contribute to heart problems.
Meanwhile, the most severe form of migraine — which also causes visual disturbance — could be linked to a heart defect called patent foramen ovale (PFO), says Dr Lindsay.
This defect, essentially a hole in the heart, allows blood to cross from veins into the arteries, bypassing the lungs, which would normally filter out certain chemicals or ‘debris’ such as tiny blood clots (raising the risk of stroke). It’s not known why PFOs can trigger migraine.
‘One study found PFOs in 25 per cent of the normal population, but in 62 per cent of those suffering from migraine,’ says Dr Lindsay.
Slightly yellow or skin-coloured lumps on the hands or ankles may be a sign of familial hypercholesterolaemia (FH).
Around 100,000 Britons don’t realise they suffer from this inherited form of high cholesterol, which puts them at high risk of heart problems from a young age.
The condition means the body cannot clear ‘bad’ LDL cholesterol from the blood.
Although there are often no obvious symptoms, some people occasionally get lumps on the tendons, especially the Achilles tendons just above the heel, or sometimes on the back of their hands just below the knuckles, says Dr Lindsay. These lumps are made up of cholesterol deposits.
If you find these deposits, particularly if there is a history in the family of heart problems at a young age, it would be worth consulting your GP, advises Dr Lindsay.
Yellow, waxy deposits in the skin around the eye, or a creamy deposit visible in the eye (where the white meets the iris) can also be a sign of high cholesterol in anyone, regardless of FH.
FLU THAT WON’T GO AWAY
‘Flu’ that doesn’t improve after five or six days can be a symptom of heart failure, where the heart is no longer able to pump as efficiently.
‘The symptoms may be put down to a bug when they first appear — patients often complain of feeling tired and breathless, but there is no joint pain, which you generally get with flu,’ says Dr Witte.
'Flu' that doesn't improve after five or six days can be a symptom of heart failure, where the heart is no longer able to pump as efficiently
‘Flu’ may also be linked to myocarditis, a viral infection that leads to inflammation and damage to the heart.
This can develop at the same time as, or more often just after, a viral throat or chest infection and is often mistaken for an unusually long bout of flu.
The majority of cases clear up within a week, but sometimes the inflammation in the heart lasts longer.
Symptoms include chest pain, fever, an irregular heartbeat and shortness of breath.
DIZZY SPELLS OR ‘VACANT’ EPISODES
The feeling of not being 100 per cent focused could be due to an underlying electrical disease of the heart, or arrhythmia.
This is where the heartbeat is too slow, too fast or irregular because of a disturbance in the heart’s normal electrical activity.
‘It makes people feel like they’re not “with it” because their blood pressure drops, their brain doesn’t get sufficient blood and they feel dizzy,’ says Dr Witte.
A simple test for arrhythmia is to take your pulse and check for irregularity. In addition, light-headedness or unsteadiness on standing from sitting or lying down can indicate low blood pressure, says Dr Matthew Fay, a GP in Shipley, West Yorkshire.
Hair loss in men, especially on the crown of the head, can be a sign of heart problems.
A study from Harvard Medical School, published in the Archives of Internal Medicine, found that men with severe vertex baldnessn — balding at the crown of the head — had a 36 per cent increased risk of heart disease; men with moderate crown balding had a 32 per cent increased risk; while mild balding on the crown carried a 23 per cent increased risk.
One study found that men with severe vertex baldness – balding at the crown of the head – had a 36 per cent increased risk of heart disease
Men with frontal baldness had just a 9 per cent increased risk. One theory is that high testosterone, which is linked to baldness, may also be linked to heart problems.
The higher a man’s level of natural testosterone, the higher his risk of heart problems, says research from the University of California.
It’s possible high testosterone levels also increase blood pressure, which is linked with heart disease.
Another theory is that a lack of blood supply to the hair follicles, which causes them to die off, may be related to poor circulation.
One of the easiest ways for doctors to check how much oxygen is circulating in the blood is to check the nails, toes or lips.
Oxygenated blood is bright red, so pink means a healthy circulation.
Deoxygenated blood looks blue (which is why our veins look blue). Blue fingers and nails can suggest the body is low on oxygen because blood is not being pumped around the body properly.
This can be a warning sign of heart failure, although Dr Fay urges caution, as it can also be a sign of lung disease or Raynaud’s syndrome, a condition affecting blood supply to the extremities.
Erectile dysfunction is one of the earliest signs of vascular disease and should never be ignored. The body needs a good blood supply for an erection.
‘Erectile problems are actually a very clear barometer of cardiovascular health,’ says Raj Persad, a urologist at Bristol Royal Infirmary.
‘That’s because the penile arteries are smaller than coronary ones, so become furred up faster.’
Cardiologist Graham Jackson, of the Sexual Advice Association, adds: ‘A man in his 40s with erectile dysfunction has a 50-fold greater risk of having a heart attack over the next ten years.
'It’s actually a predictor of death rather than simply heart disease.’
Symptoms of heart disease vary widely between men and women, explains Dr Ghada Mikhail, a consultant cardiologist at Imperial College Healthcare NHS Trust and the Bupa Cromwell Hospital.
‘Men tend to experience a tightness in their chest, going down the left arm,’ she says.
‘It can also present like that in women, but there can be less typical symptoms such as shortness of breath, jaw discomfort, shoulder, upper abdominal or back pain, sweating, vomiting, or general fatigue.
‘The chances are these symptoms are not related to heart disease, but they could be, and the key is that many women still think of heart disease as a man’s condition.’
It’s not just the arteries in your heart you have to worry about.
‘Cramping pain in the calves on walking can be a sign of peripheral vascular disease, disease of the arteries of the legs,’ says Dr Fay.
A classic trait of peripheral vascular disease is that pain usually ceases after five to ten minutes of rest.
‘And if you have vascular disease in one place, you should consider that you have it in all areas, such as the heart,’ he adds.
‘Having a crease in your earlobe has also been associated with high cholesterol,’ says Dr Lindsay.
Indeed, a study of the post-mortem results of 300 men, reported in the British Heart Journal, found that earlobe creases were often linked to deaths caused by cardiovascular problems.
One theory is that creases occur as a result of malformed blood vessels, which may also be true of those supplying the heart.
‘However, don’t be reassured about the state of your heart health if you don’t have a crease,’ cautions Dr Lindsay.
Snoring is a common symptom of sleep apnoea, where breathing may cease for several seconds at a time, before the person briefly wakes.
The most common type is obstructive sleep apnoea, where the tissues at the back of the throat collapse, blocking the airways.
Another form, central sleep apnoea, occurs when the brain doesn’t send the right signals to tell you to breathe when you are asleep.
This can be an underlying sign of heart failure, says Dr Witte.
For more information, go to heratheart.org.uk, heartuk.org.uk