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  • Cardiovascular Disease

    General Signs and Symptoms

    Doctors can usually diagnose cardiovascular disease by observing symptoms and risk factors from the medical history and signs from the physical exam. Certain symptoms tend to be more or less common in certain conditions. For example, shortness of breath often characterizes heart failure, whereas chest pain is often present in angina. Keep in mind that not all signs and symptoms are present for all types of cardiovascular disease. Some are present only in a few conditions, others are in several different conditions, and all can be indicative of many things other than cardiovascular disease. And sometimes, there are no symptoms at all until the disease reaches a late stage.
    Major symptoms suggestive of cardiovascular conditions include:
    • Chest Pain —The specific type and location of pain can tell a lot about its cause. For example, a tightness or squeezing sensation in the chest often indicates angina or heart attack . On the other hand, chest pain that gets worse when lying down and doesn’t worsen with exertion is more likely to be a symptom of pericarditis , an inflammation of the sac surrounding the heart.
    • Leg Pain —Peripheral vascular disease, often leads to cramping and fatigue in the legs with exertion.
    • Shortness of Breath —Fluid backing up into the lungs from a failing heart leads to shortness of breath, which is often made worse by laying down. While shortness of breath is common to many types of cardiovascular conditions, it is no by no means limited to CVD. The symptom is very common, for example, in lung disease.
      Fluid in the Lungs
      Pulmonary Edema
      © 2011 Nucleus Medical Media, Inc.
    • Fatigue —Fatigue is another common symptom of cardiovascular disease, presumably caused by insufficient blood flow to the muscles along with the decreased availability of oxygen due to fluid in the lungs.
    • Palpitations —A heart that is beating at an unusual force, rate, or rhythm, could just be an indication of anxiety or too much caffeine. However, abnormal heartbeats—especially if they occur in conjunction with other symptoms like fatigue or fainting—could hint at a more serious underlying condition such as an arrhythmia .
    • Lightheadedness and Fainting —Insufficient blood flow to the brain can cause lightheadedness or fainting. This may be due to abnormal heart rate or rhythm, or to insufficient cardiac output. Of course, fainting may have many other causes ranging from anxiety to epilepsy, and in most individuals is not due to CVD.
    Signs suggestive of cardiovascular conditions include:
    • Pale, clammy appearance
    • Cyanosis (blue tinge to the skin), particularly in the extremities
    • Rapid or shallow breathing
    • Rapid and/or irregular heart rate
    • High or low blood pressure
    • Swollen veins in the neck
    • Swelling in the feet and ankles
    • Abnormalities in the retina (back of the eye)
    • Enlarged heart (measured by placing hand on chest)
    • Extra or abnormal heart sounds (via stethoscope)
    • Fluid in the lungs (via stethoscope)
    • Abnormal sounds of arterial blood flow throughout the body (via stethoscope)
    • Pulsating abdominal mass (aortic aneurysm)
    • Cool extremities
    • Reduced or absent pulses in the extremities


    American Heart Association http://www.americanheart.org

    Heart Rhythm Society http://www.hrsonline.org/


    Health Canada http://www.hc-sc.gc.ca/index%5Fe.html

    Heart and Stroke Foundation http://ww2.heartandstroke.ca/


    Diagnosis of Heart Disease. In: Berkow R and Beers MH, eds. The Merck Manual of Medical Information—Home Edition . [Internet Edition]. Merck & Co., Inc; 2000. Available at: http://www.merck.com/pubs/mmanual%5Fhome/ . Accessed December 16, 2002.

    Revision Information

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