By James M. Rippe

Symptoms are feelings or conditions that a patient experiences and then tries to describe to his or her physician. Signs are findings that the physician derives from the physical examination that point toward the proper cardiac diagnosis. Depending on the circumstances and severity, some symptoms (conditions you experience) may represent signs of serious cardiac disease to your physician or may not be worrisome at all.

  • Chest pain

    Chest pain probably is the most common symptom for which people go to see a cardiologist. Although chest pain can signify heart problems, it also can stem from a wide variety of structures in the chest, neck, and back that have no relation (other than proximity) to the heart.

    Pain caused by angina or heart attack usually is located beneath the breastbone but may also be located in the front of the chest or either arm, neck, cheeks, teeth, or high in the middle of the back. Exercise, strong emotion, or stress may also provoke chest pain.

    Very short bouts of pain lasting five to ten seconds typically are not angina or heart-related but are more likely to be musculoskeletal pain. If you have concern about any chest discomfort, going to a medical facility and having it further evaluated is imperative.

  • Shortness of breath

    Shortness of breath is a major cardiac symptom. But determining whether this symptom comes from problems with the heart, the lungs, or some other organ system typically is difficult. Exertion can cause temporary shortness of breath in otherwise healthy individuals who are working or exercising strenuously or in sedentary individuals who are working even moderately.

    But an abnormally uncomfortable awareness of breathing or difficulty breathing can be a symptom of a medical problem. Shortness of breath that occurs when you’re at rest, for example, is considered a strong cardiac symptom. If shortness of breath lasts longer than five minutes after activity or occurs when you’re at rest, have your doctor evaluate it.

  • Loss of consciousness

    Loss of consciousness usually results from reduced blood supply to the brain. Perhaps the most common loss of consciousness is what people usually call a fainting episode. This temporary condition may be brought on by being in a warm or constricted environment or in a highly emotional state. Such episodes often are preceded by dizziness and/or a sense of fading to black. The condition may also be accompanied by nausea and a cold sweat.

    When the heart is the cause, loss of consciousness typically occurs rapidly and without preceding events. Cardiac conditions ranging from rhythm disturbances (electrical problems in the heart) to mechanical problems potentially can cause fainting or a blackout. Because such cardiac problems can be serious, never dismiss the loss of consciousness in an otherwise healthy individual as a fainting episode until that person has a complete medical workup.

  • Cardiovascular collapse

    You can’t experience a more dramatic symptom or greater emergency than cardiovascular collapse, also called sudden cardiac death. Of course, cardiovascular collapse results in a sudden loss of consciousness, but the victim typically has no pulse and stops breathing. The victim of a seizure or fainting spell, on the other hand, has a pulse and continues breathing.

    Cardiovascular collapse can occur as a complication in an individual who has known heart disease but sometimes may be the first manifestation of an acute heart attack or rhythm problem. When cardiovascular collapse occurs, resuscitation must take place within a very few minutes or death inevitably follows.

  • Palpitations

    Palpitations, which can be defined as an unpleasant awareness of a rapid or forceful beating of the heart, may indicate anything from serious cardiac rhythm problems to nothing worrisome at all. Typically, an individual who is experiencing palpitations describes a sensation of a skipped beat; however, people also may describe a rapid heartbeat or a sensation of lightheadedness.

    Whenever the palpitation is accompanied by lightheadedness or loss of consciousness, a further workup is imperative to determine whether serious, underlying heart-rhythm problems are present. Often, the simplest underlying causes of palpitations can be turned around by getting more sleep, drinking less coffee or other caffeinated beverages, decreasing alcohol consumption, or trying to reduce the amount of stress in your life.

  • Edema

    Edema is an abnormal accumulation of fluid in the body, a type of swelling, and has many causes. The location and distribution of the swelling is helpful for determining what causes it. If edema occurs in the legs, it usually is characteristic of heart failure or of problems with the veins of the legs.

    Edema with a cardiac origin typically is symmetric, which means that it involves both legs. An abnormal gathering of fluid in the lungs is called pulmonary edema, and the typical symptom is shortness of breath. This symptom also can be typical in a patient with heart failure. Abnormal gathering of fluid in either the legs or the lungs always indicates the need for a complete cardiac workup.

  • Cyanosis

    Cyanosis, the bluish discoloration of the skin resulting from inadequate oxygen in the blood, is a sign and a symptom. One form of cyanosis occurs when unoxygenated blood that normally is pumped through the right side of the heart somehow passes into the left ventricle and is pumped out to the body. This anomaly commonly occurs in congenital abnormalities that create abnormal openings between the right and left sides of the heart.

    The second type of cyanosis commonly is caused by constriction of blood vessels in your limbs or peripheries and may be the result of a low output from the heart or from exposure to cold air or water. Whether the cyanosis is central or peripheral in nature guides a physician in the search for which type of underlying condition is causing the cyanosis.

  • Cough

    As anyone who has had a head cold knows, a cough can accompany a viral illness. It can also represent a variety of underlying causes such as cancers, allergies, abnormalities of the lungs, or abnormalities of the breathing tube. The cardiovascular disorders that result in cough are those that cause abnormal accumulations of fluid in the lungs, such as significant heart failure.

  • Coughing up blood

    Coughing up blood of any kind — from small streaks in sputum to large quantities — is called hemoptysis. This condition can result from a variety of very serious diseases of the lungs or even some forms of cancer. Whatever the cause, coughing up blood-tinged secretions never is normal and may represent a medical emergency.

  • Fatigue

    In busy, hectic lives, fatigue may stem from a bewilderingly large number of underlying causes ranging from depression to side effects of drugs to physical illnesses, including cardiac problems. The ordinary fatigue you feel after working hard is normal, even when you have to crash into bed early. But a significant level of enduring fatigue should always prompt a call to your doctor, who may want to do an appropriate medical workup to determine possible underlying causes.