8 sneaky signs of heart disease you shouldn’t ignore

Heart disease remains one of the leading health concerns for men and women alike—but it doesn’t always announce itself with severe chest pain.

“In many cases, the earliest warnings are subtle, easily brushed off, or mistaken for everyday stress or fatigue,” said Kevin Kheder, MD, an interventional and structural cardiologist at the Hoag Jeffrey M. Carlton Heart & Vascular Institute.

But prevention begins with awareness. Understanding these lesser-known symptoms can empower you to seek care sooner, protect your long-term heart health, and stay active in the moments that matter.

1. Unusual fatigue that won’t go away

If you’re exhausted after activities you normally handle with ease—carrying groceries, walking upstairs, or even getting ready in the morning—it may be more than burnout. For some people, particularly women, persistent fatigue can be an early sign that the heart is working harder than it should.

2. Shortness of breath during routine tasks

Feeling breathless after exercise is normal. Feeling breathless while talking or getting dressed is not.    “When the heart can’t pump efficiently, the lungs don’t receive enough oxygen-rich blood, leading to that ‘can’t catch my breath’ feeling,” said Dr. Kheder.

3. Subtle chest pressure or discomfort

Heart-related chest symptoms aren’t always sharp or dramatic. They can feel like pressure, heaviness, squeezing, indigestion or even a sense of fullness. These sensations may come and go, making them easy to overlook.

4. Persistent heartburn or “indigestion-like” pain

Many people are surprised to learn that heart disease can mimic stomach issues. If you frequently experience upper abdominal discomfort, nausea or a burning sensation—especially if it’s new or occurs with exertion—it’s worth discussing with your provider.

5. Swelling in the ankles, feet or legs

Fluid buildup in the lower body may signal that the heart isn’t circulating blood effectively. While swelling can have many causes, new or worsening puffiness, especially by day’s end, is something worth checking out.

6. Dizziness or lightheadedness

Feeling faint or unsteady can occur when the heart isn’t supplying the brain with enough blood. If dizziness is paired with shortness of breath, chest pressure or fatigue, it’s especially important to seek care.

7. Irregular heartbeat or “fluttering” sensations

Occasional skipped beats can be normal, but frequent palpitations, fluttering or a racing heart may signal an underlying arrhythmia. Trust your intuition—if something feels off, it’s worth evaluating.

8. Jaw, neck, back or arm discomfort

Heart pain isn’t always located in the chest.    “Some people experience discomfort radiating to the jaw, upper back, shoulders or arms. This ‘referred pain’ can be dull, achy or tight, and may come on with activity,” said Dr. Kheder.

Why these symptoms are easy to miss

Life is busy. Fatigue gets blamed on stress. Heartburn feels like something you ate. Swelling gets attributed to salty food or long workdays. But your body’s early warning signs matter and recognizing them could help prevent a major cardiac event.    If you notice persistent or unusual symptoms—especially if they appear during activity or are new for you—schedule an evaluation.    If symptoms are sudden, severe or include chest pain, difficulty breathing or fainting, call 911 immediately.

Learn more about Hoag’s comprehensive cardiovascular services.