Transcription
Did you know that the number of pillows you sleep with could be an important clue to hidden heart disease, or that your eyes, skin, and nails can reveal vital information about the health of your heart?
Heart disease is something I diagnose and treat every day, and it's far more common than most people realize. In fact, around half of American adults over the age of 40 may have some form of hidden or undiagnosed heart disease. You heard that right, half. That's tens of millions of people walking around right now with a heart condition they know nothing about. One of them could be you.
Today, I'm going to show you seven hidden signs of heart disease that could help save your life or the life of someone you care about. These are signs you can look for right now. They're the same clues I look for when assessing my own patients. You don't need to be a cardiologist to spot them yourself. So, let's get started.
Number one, how many pillows do you sleep with? This might seem like a strange question, and I often get a few funny looks when I ask it, but I've found it's one of the most useful questions for identifying hidden heart failure. What I'm really asking is this: Can you lie completely flat and breathe comfortably, or do you become short of breath when you lie down?
The heart's job is to pump blood from the lungs to the rest of the body and back again. When the heart starts to struggle, blood can begin to back up into the lungs. As the pressure builds, fluid leaks from the blood vessels into the lung tissue. When you're upright, gravity helps keep as much of this fluid lower down in the lungs, but when you lie flat, the fluid spreads more evenly throughout the lungs, making it hard to breathe. It's almost like trying to breathe with a layer of water inside your lungs. This condition is called pulmonary edema. You can see it in these chest x-rays. The white areas represent fluid that's built up within the lungs.
The tricky part is that these changes often happen very slowly. Most people don't suddenly notice they're short of breath lying flat. Instead, they start using an extra pillow, then another. They assume it's just more comfortable. So, after years of asking patients whether they felt breathless lying down, I realized many didn't recognize the symptom. So, I started asking a different question, like, "How many pillows do you sleep with?" And that question often tells me much more. So, ask yourself, could you comfortably sleep completely flat tonight? Or do you need multiple pillows to breathe easy?
Number two, can you climb a flight of stairs? Again, this sounds like a very simple question. The reason it's important is that many people with heart disease feel completely normal during everyday activities. They go shopping, they go to work, they walk around the neighborhood. I've had patients with significant heart disease who could still walk a mile without any obvious problems. But, stairs are different. Walking uphill or climbing stairs places much greater demands on the heart. That's often when symptoms first appear. If you find yourself unusually short of breath at the top of a single flight of stairs, especially if this is a change from your normal level of fitness, it's something worth paying attention to. Sometimes the earliest signs of heart disease only appear when the heart is pushed a little harder.
Number three, are your ankles swollen? This is one of the easiest signs to check yourself. Sometimes all you notice is that your shoes feel a little tighter at the end of the day, or your socks leave deep marks around your ankles. What we're looking for is something called pitting edema, and you can test for it right now. Press firmly on your ankle or shin with your thumb for about 15 to 30 seconds, then let go. If a dent remains in the skin for a few moments, that's called pitting edema. What you're seeing is fluid that has leaked out of the blood vessels and collected in the tissues. This can happen when blood backs up because the heart isn't pumping effectively. It's the same basic process we talked about earlier when fluid builds up in the lungs.
Now, swelling doesn't automatically mean heart disease. You can also see it in kidney disease, pregnancy, and several other conditions. If it's present alongside some of the other signs in this video, it should raise a red flag.
Number four, is your pulse regular? There is a heart condition you can screen for right now using nothing more than your fingers. Place three fingers on your wrist just below your thumb, as shown. Can you feel your pulse? Now, pay attention to the rhythm. Does it feel steady and regular, or does it seem completely unpredictable? If your pulse feels irregular, you could be experiencing a condition called atrial fibrillation. The heart has four chambers, two atria and two ventricles. Normally, the electrical system coordinates all four chambers so they beat in an organized way. But in atrial fibrillation, the atria start firing chaotically and twitch rather than contracting properly. This creates an irregular pulse.
The reason this matters is that blood can pool inside the atria and form clots. Those clots can travel through the bloodstream. If a clot reaches the brain, it can cause a stroke. If it blocks blood flow to the intestines, it can cause a serious and potentially life-threatening condition called bowel ischemia. The good news is that many modern smartwatches can detect irregular rhythms and alert you to them. But sometimes your fingers can pick it up first.
If you're finding this video useful, please subscribe and leave a comment. I've been treating patients for almost 20 years, and I make these videos to share practical medical knowledge that anyone can use to live a longer and healthier life.
Number five, watch your neck and fingernails. The heart contains several valves that help keep blood flowing in the correct direction. One of the most important is the aortic valve. If this valve becomes leaky, a condition called aortic regurgitation, some blood flows backwards instead of forwards. Over time, this can place extra strain on the heart and eventually lead to heart failure. What's fascinating is that this condition can sometimes be seen from the outside. You may notice visible pulsations in your neck, or if you look carefully at your fingernails, you may see tiny pulsations in the nail beds. This is called Quincke's sign. Some people even develop visible pulsations of the uvula at the back of the throat, known as Müller's sign. Others notice their head subtly nodding with each heartbeat, known as de Musset's sign. These findings are uncommon, but when present, they can be important clues to significant aortic valve disease.
Number six, what do your fingers look like? Your hands can reveal a surprising amount about your health. Try this simple test. Place your index fingers together and your thumbnails together. Can you see a small diamond-shaped gap between the nails? Good. Now compare it with this image. If that gap is missing, you may have a finding known as clubbing. Clubbing occurs when the ends of the fingers become enlarged and the nail curves more than usual. It's often a sign that the body has been exposed to low oxygen levels for a long period of time. Heart disease can cause it, but so can many lung diseases and several other medical conditions as well. If you think you may have clubbing, it's worth getting checked by a healthcare professional.
Number seven, check your eyelids. Finally, have a look at your eyelids. Do you notice any yellow patches around them, especially near the inner corners of the eyes? These are called xanthelasma. They're deposits of cholesterol underneath the skin. Xanthelasma itself doesn't mean you have heart disease. However, it can be a clue that your cholesterol levels are abnormal, and abnormal cholesterol is one of the major risk factors for atherosclerosis, and the buildup of plaque inside the arteries. Over time, that process can lead to heart attack, stroke, and other cardiovascular problems. So, while xanthelasma isn't dangerous by itself, it may be a sign that it's time to have your cholesterol checked.
These signs don't necessarily mean you have heart disease, but they're clues. Clues that I use every day when assessing patients. If you notice any of these signs in yourself, don't ignore them. Speak with your doctor and get properly assessed. The earlier heart disease is detected, the more we can do to prevent serious complications later on.
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