Early Signs Your Heart May Be in Trouble

Your heart is your body’s engine. It pumps oxygen-rich blood to every organ, every minute of every day. But what happens when the heart isn’t doing its job as well as it should?

Poor heart function doesn’t always announce itself with dramatic chest pain or a sudden collapse. Often, the early signs are subtle, creeping in quietly until they become impossible to ignore.

Whether you’re managing risk factors like high blood pressure or simply want to stay informed, recognizing the early signs of cardiovascular trouble could make a life-saving difference.

Pay Attention and Trust Yourself

If we pay attention, our body gives us clues about our heart health. Subtle changes in energy, breathing, or circulation can indicate various types of heart trouble.

Heart rhythm disorders (arrhythmias) affect how regularly and efficiently the heart beats. By contrast, heart failure describes the heart’s inability to supply enough blood to meet the body’s needs. When either issue begins to develop, your body can start showing you the signs long before you receive a formal diagnosis. Some signs are distinct, but others can overlap.

1.Fatigue That Doesn’t Add Up

We all get tired. But if you’re constantly exhausted after mild activity, such as walking across a room or climbing a single flight of stairs, it could be more than just a busy lifestyle or poor sleep. When your heart can’t pump efficiently, your muscles and tissues aren’t getting the oxygen they need, leading to early and persistent fatigue.

Whether from weak pumping action (heart failure) or an erratic rhythm (arrhythmia), both can leave you feeling unusually drained.

How it feels:

• You might wake up tired despite a full night’s rest
• Physical tasks you once handled easily now leave you wiped out.
• You may notice your stamina slowly dropping over time

This type of fatigue often goes unnoticed because it’s easy to explain away. However, if it persists and worsens, it’s worth discussing with your healthcare provider.

2. Shortness of Breath

Breathing trouble usually points to one of two systems: the heart or the lungs. When it stems from heart failure, it often means fluid is backing up into the lungs, leading to pulmonary edema. Arrhythmias can cause shortness of breath by limiting the heart’s ability to fill and pump, which can leave you gasping, even if your lungs are otherwise healthy.

In both cases, even mild activity can leave you feeling short of breath.

Signs that show up:

• You feel winded walking to the mailbox or doing chores
• You need to sleep propped up on pillows
• You wake up at night, struggling to catch your breath

Shortness of breath can stem from many causes, but when paired with other symptoms on this list, it’s probably your heart trying to tell you it’s struggling, and it deserves a closer look.

3. Swelling in the Lower Body

Although rhythm issues can impact circulation, edema in the legs, ankles, or abdomen is commonly a sign of heart failure.

When the heart isn’t pumping efficiently, pressure in the veins of the lower extremities causes fluid to leak from the vessels into surrounding tissues. This initiates a cycle in which the kidneys may begin retaining fluid, leading to increased swelling. The result? Puffy legs, tight shoes, and a bloated sensation that doesn’t improve. Note that you don’t necessarily need to have swelling in all three areas to indicate signs of heart failure. If swelling occurs and you don’t have a clear explanation for it, consult your doctor.

You might notice:

• Sock marks that don’t fade quickly
• Shoes feeling tight by the end of the day
• A sense of heaviness or fullness in the legs or belly

Swelling is common and can stem from many causes, but in the context of cardiovascular problems, it’s usually a sign that the body is struggling with fluid regulation.

4. Rapid or Irregular Heartbeat

A flutter here or there isn’t necessarily cause for alarm. But if you’re regularly feeling your heart race, skip beats, or pound hard in your chest without an apparent reason, your heart may be under stress.

This is a hallmark symptom of rhythm disorders like atrial fibrillation or supraventricular tachycardia.

Pay attention if:

• Your pulse feels consistently fast or irregular
• You feel faint or dizzy with palpitations
• Your symptoms get worse during activity or stress

Some arrhythmias can be harmless. Others can lead to strokes or sudden cardiac events. Either way, if your heartbeat feels “off” more often than not, don’t ignore it.

5. Chest Discomfort (Not Always Pain)

We tend to imagine chest pain as the big, unmistakable signal of a heart attack, but that’s not the only reason for chest discomfort. Sometimes it is attributed to something more benign, like acid reflux or anxiety, and other times it’s a signal that something more severe is happening, like a pulmonary embolism or pericarditis. Either way, check it out because the chest shouldn’t hurt or feel uncomfortable.

In the case of heart failure, there will be increased pressure, and an arrhythmia may feel like fluttering, unease, or a pounding in the chest.

How it can feel:

• A tightness or squeezing in the chest
• Pressure that worsens with activity and improves with rest
• Discomfort that spreads to the shoulders, neck, jaw, or arms

Chest symptoms are always a reason to seek medical evaluation. Even if it’s mild or intermittent, it’s better to investigate early.

6. Dizziness or Lightheadedness

Your brain relies on steady blood flow to function properly. When your heart isn’t pumping adequately, your brain may not get the oxygen it needs, leaving you feeling dizzy, foggy, or faint.

Bradycardia (a slow heart rate) and tachycardia (a fast heart rate) are rhythm issues that frequently cause these symptoms. In heart failure, poor perfusion (the exchange of nutrients and oxygen from blood to organs) can result in similar effects.

You might notice:

• Feeling faint when you stand up
• Sudden bouts of lightheadedness after exertion
• Unexplained balance issues or foggy thinking

These symptoms can also suggest low blood pressure, dehydration, or neurological conditions, but in combination with other heart-related signs, they warrant a cardiovascular workup.

7. Weight Gain That Creeps Up Fast

This isn’t the slow weight gain of aging or overindulgence; it’s sudden and seemingly inexplicable. Heart failure is the primary culprit here, and weight gain can be one of the earliest signs of fluid retention. In arrhythmias, this is uncommon.

Watch for:

• A gain of 2–3 pounds in a day or 5 pounds in a week
• Tight clothing without changes in diet
• Accompanying swelling or bloating

Sudden weight gain, especially when accompanied by swelling or shortness of breath, can be an early clue that the heart isn’t keeping up. If you notice unexplained changes on the scale, it’s worth discussing with your provider before more noticeable symptoms develop.

8. Cold Hands and Feet

Poor circulation is often a silent indicator of poor cardiovascular output. When the heart isn’t pumping efficiently, the body prioritizes blood flow to vital organs, leaving your hands, feet, and lower legs feeling colder than usual.

While it is possible for this to show up with heart rhythm issues, this is typically associated with heart failure.

Signs that show up:

• Hands and feet that feel cold, even in warm environments
• A bluish tint to the fingers or toes (cyanosis)
• Slow-healing cuts, scrapes, or sores, especially on the feet

Reduced circulation can affect more than comfort. It increases the risk of ulcers, infections, and, if left untreated, tissue damage due to lack of blood flow.

What To Do

If you’re reading this and mentally checking boxes, don’t panic, but do take action.

• Schedule a Check-Up: Discuss your symptoms with your doctor, even if they seem minor. Blood tests, an EKG, and an echocardiogram can give a clearer picture of how your heart is functioning.
• Track Your Symptoms: Keep a simple journal of what you’re feeling – fatigue levels, swelling, heart rate, activities, even your diet. These notes can help your provider make a faster, more accurate diagnosis.
• Know Your Risk Factors: Conditions like high blood pressure, diabetes, smoking, and a family history of heart disease all increase your risk. If you have any of these, be extra vigilant.

Your heart doesn’t always yell when it’s in trouble. Sometimes, it whispers. Symptoms can start simple and easily explainable, but over time, they can significantly impact your quality of life and overall health. The earlier you catch it, whether it’s a weak pump or an irregular rhythm, the more treatment options will be available, and the better your outcomes will be.

If you’ve experienced any of these symptoms, or unusual ones that didn’t make this list, don’t ignore what your body is trying to tell you.

If you are experiencing a sudden onset of symptoms or an urgent situation, please dial 911 or have someone take you to the closest ER. Some heart issues, including heart attacks, require emergency attention.

Dr. Tordini is a part of Florida Medical Clinic Orlando Health