While cardiovascular disease is established as the leading cause of death in the U.S., its lesser-known symptoms may not always be associated with the disease. Recent findings published by the American Heart Association noted that subtle symptoms like fatigue, sleep disturbance, weight gain and even depression may predict acute cardiac events requiring hospitalization.
Subtle symptoms like fatigue, sleep disturbance, weight gain and even depression may predict acute cardiac events.
Yet, many people remain unaware of these lesser-known symptoms, the report stated.
“CVD can develop over time, and symptoms are experienced on a spectrum of severity. This can delay diagnosis and treatment and points to the need for screening, tracking and monitoring,” said Corrine Y. Jurgens, PhD, RN, ANP, FAHA, AHA, the report chair and associate professor at Boston College’s Connell School of Nursing. “Symptoms may go unrecognized or unreported—people may not think symptoms are important. This is a good reason to establish a baseline symptom profile for an individual and track them over time to detect changes and chart symptom progression.”
While shortness of breath is a well-known heart failure symptom and a common reason adults seek medical care, persistent and lesser-known symptoms may signal it’s time to consult with a health care professional:
- Depression and anxiety
- Brain fog and memory problems
- Upset stomach, nausea, vomiting and loss of appetite
- Fatigue
- Exercise intolerance (related to fatigue and shortness of breath)
- Palpitations and pain (chest and otherwise)
Women with heart failure report a wider variety of symptoms and are more likely to experience depression and anxiety, Jurgens said, and report a lower quality of life compared to men with the condition.
Women with heart failure report a wider variety of symptoms and are more likely to experience depression and anxiety.
Depression and CVD: The importance of screening
National survey data reveals people with cardiac disease have about twice the rate of depression compared to people without any medical condition (10% vs. 5%). Several types of depression exist, and symptoms may show up in slightly different ways.
The National Institute of Mental Health estimates that 19.4 million adults, or 7.8% of all adults in the U.S., had at least one episode of major depression in 2019. Episodes of major depression were more common among women (9.6% vs. 6% in men) and people who describe themselves as being of two or more races or ethnicities (13.7%).
According to the AHA, depression should be considered a risk factor for worse outcomes after an acute coronary event or diagnosis.
“Depression symptoms should be routinely monitored over time,” Jurgens said. “An annual screening is recommended in a primary care setting, due to the prevalence of the condition among individuals with CVD. Depression can be a recurring illness, so tracking symptoms at more frequent intervals (for example, three or six months) could be helpful in identifying and addressing CVD symptoms more quickly.”
Baseline symptoms of depression can be captured using a brief, self-reporting tool such as the Patient Health Questionnaire-9, administered by a health care provider, said Jurgens. Scores may indicate a need for referral to a psychologist or other mental health provider for a more formal evaluation of depression and related symptom management.
Experts recommend both cognitive function and depression levels should be regularly assessed throughout the course of all cardiovascular diseases due to the specific influence they have on a person’s ability to detect symptoms and changes in their condition.
Those with Medicare coverage are offered multiple prevention screenings through the free annual Medicare Wellness Visit. Ask your physician about your risk factors related to heart failure and other cardiovascular diseases during your visit.
