Selected Podcast
Sneaky Heart Disease Symptoms
Signs of heart disease or sneaky/silent symptoms of heart disease. The goal of this segment to remind the audiences of signs and symptoms of heart disease, both the ones they know and the ones they may not thinking about – the silent or sneaky ones, such as extreme tiredness or nausea, pain/swelling, stress and anxiety, etc.
Featuring:
Abigail Qin-Nelson, DO
Abigail Qin-Nelson, DO is Board-certified in interventional cardiology, general cardiology, nuclear cardiology and internal medicine, Dr. Qin-Nelson received her undergraduate degree in biomedical engineering and earned a doctorate from Nova Southeastern University College of Osteopathic Medicine in Florida. Transcription:
Scott Webb: Sometimes the symptoms of heart disease are obvious and sometimes they are sneaky. For example, extreme tiredness, nausea, pain and swelling, stress, and anxiety may be the signs of heart disease. And here to help us understand the common and less common signs of heart disease and the importance of knowing our numbers is Dr. Abigail Nelson. She's a cardiologist with Franciscan Health.
This is the Franciscan Health Doc Pod. I'm Scott Webb. Dr. Nelson, the symptoms of heart disease are often not that obvious, right? So we're going to kind of talk about that today, the less obvious signs and symptoms of heart disease. And as we get rolling here, and maybe you can just sort of take us through, since we know that cardiac issues, as I'm saying, don't always present in the most obvious ways, what are some things that we should be on the lookout for, signs and symptoms and so on?
Dr. Abigail Qin-Nelson: You're correct. Not all cardiac symptoms are the obvious crushing chest pain that you typically see on television. A lot of times patient can have very vague symptoms such as unexplained fatigue, exhaustion, shortness of breath or even things like nausea and indigestion.
Scott Webb: Yeah. And I think that that's one of the most concerning things about cardiac issues, heart disease is just that, so many of these things, you say fatigue and exhaustion, maybe that's something else, maybe you're not sleeping well, maybe you have sleep apnea, maybe you're still recovering from COVID, right? So maybe you can just sort of tell us, you know, like when should we be concerned about our overall health? But if we're experiencing things like fatigue and exhaustion, how do we know that that's a heart issue and not something else?
Dr. Abigail Qin-Nelson: These vague symptoms definitely can be result of restricted blood flow to the heart caused by blockages. And these symptoms typically will be worse with activity or exacerbated by anxiety or stress. Now, if these symptoms continue to recur and persist without improvement, then patients should definitely concern visiting their doctors for further evaluation and not just to brush them aside and continue to ignore them. As you said, a lot of risk factors are involved such as sleep apnea, family history, smoking, high cholesterol. So being aware of potential risk factors that, you know, patient could have, putting them at higher risk is also very important.
Scott Webb: Yeah, it definitely is. And you mentioned risk factors. So let's talk about that. The risk factors are sort of complicating conditions, right? So yeah, we know that family history, genetics play a role in a lot of the conditions that people suffer, but also things that we do to ourselves and behavior, lifestyle, whether that's smoking, untreated high cholesterol, diabetes, high blood pressure, and so on. So maybe you can talk about that a little bit, the things that we tend to not go to the doctor for that we should, things that aren't being treated, and just generally how we may be contributing to our heart conditions.
Dr. Abigail Qin-Nelson: As you mentioned, family history is something that most people are well aware of. However, things like high blood pressure, high cholesterol, smoking, inactivity, not exercising, being overweight, age, diabetes, and even sleep apnea can definitely put you at risk for developing heart disease at various times.
The most important things to understand is your numbers, as they say. Be well aware of your blood sugar numbers, blood pressure, total cholesterol and BMI. So things that you look for, you want your blood pressure goal to be less than 120/80. You want your blood sugar to be less than 100. You would like your total cholesterol to be less than 200 and BMI to be between 18 and 25. So things that you can do at home to kind of improve your own health would be to schedule regular exercise, watch the weight, be mindful of eating habits. If you're not getting adequate sleep, to be aware of that and perhaps seek help early to make sure you're not missing sleep. Continuing to be aware of your goal number, so that you can work with your physician to achieve these goals through treatment or lifestyle modification.
Scott Webb: Yeah, and we've heard, and I've definitely heard hosting podcasts that, you know, folks during COVID have been delaying healthcare. We know that time is heart, time is brain when we think about, heart conditions, heart attacks, strokes, and so on. Has that been your experience through COVID? And do you see more folks coming into the office now? Do we feel like we've kind of turned the corner a little bit and folks are back to maybe taking care of themselves a little better?
Dr. Abigail Qin-Nelson: Yes, absolutely. COVID has definitely played a very unique role in patients' health, whether you've had it or are just very cautious in avoiding public places to decrease your chance of catching COVID. It has definitely put a delay in a lot of patient's eagerness to seek healthcare for these vague symptoms. And now that things are coming down a little, we are seeing more patients returning to the office with questions and concerns. And I think it's very important that things don't get ignored due to fear. Yes, while COVID risk is concerning, so is risk of heart disease and untreated heart disease. We would rather see you in the office and address these symptoms and treatment for these symptoms in a very stable, controlled environment instead of seeing a patient for the first time when they're coming in with a full blown heart attack.
And on top of that, patients who've had COVID have also developed very unique, vague symptoms that are related to just recovery from COVID itself. And sometimes they're very difficult to distinguish between whether these are heart-related or COVID-related. So again, more important for patients to seek help early so that we can help them on their way to recovery, whether it's due to their heart or long-haul COVID symptoms.
Scott Webb: Yeah. And we've done a podcast on long haulers, and there's no doubt that it's challenging for all of us to know. Is this like residual effects from COVID or do I actually have heart disease or maybe it's both? And as you say, early screening and diagnosis is so key in almost all cases, but especially when we talk about heart disease. And along those lines, let's talk about the difference in presentation between men and women. Not only do heart disease symptoms present differently, but also how men and women may perceive their symptoms differently.
Dr. Abigail Qin-Nelson: That is correct. Men and women can have very unique presentation of heart disease. Men typically will have more common symptoms such as breaking out in a cold sweat, pain in their left arm, and indigestion. On the other hand, women typically will feel discomfort between the shoulder blades or have sleep disturbances. And again, these symptoms are very easily brushed off as something that's just, you know, stress-related or muscle-related. And oftentimes, women are busy taking care of other people and these symptoms are easily ignored. And so there can be delay in recognition and treatment due to this. So I think everyone should be cognizant of these symptoms and if they continue to persist, know that it is not something that should be ignored and should seek further evaluation sooner rather than later.
Scott Webb: Yeah, I think you're so right. As said, you've used the word today, vague, these vague symptoms, right? And it's so easy for so many of us to sort of brush things off as, "Oh, well, you know, I've got this pain between my shoulder blades, but I did lift that box earlier. So I probably just pulled a muscle," and you may have, but as you've identified today and stated, you know, if these signs and symptoms persist well beyond what would have been a pulled muscle or something like that, that's a great time to reach out to our doctors, right?
Dr. Abigail Qin-Nelson: Correct. Absolutely.
Scott Webb: Yeah. And you mentioned earlier about knowing our numbers. And maybe you can just sort of take us through that. When we say know your numbers, what does that mean exactly?
Dr. Abigail Qin-Nelson: As mentioned, some of the key numbers that you should be aware of and pay attention to are blood pressure, blood sugar, total cholesterol and BMI. Of course, there are various panels that are done during these routine tests that, you know, also play important role. But if you keep these numbers in mind, they will give you a good starting point to know what to bring up with your physician.
So your blood pressure goal should be less than 120/80. Your blood sugar goal should be less than 100. Your total cholesterol goal should be less than 200. And your BMI should be between 18 and 25. Now, when you see that your numbers are higher than these goal numbers, it is definitely a platform for you to have an in depth discussion with your physician on treatment options that can help lower these in addition to medications, which I know a lot of people can be resistant to in the beginning, but there are a lot of things you can do through diet, exercise that can help achieve your goals without medication if that is what you prefer in the beginning. But being mindful and being active in your care will help kind of get you to these goals early and prevent development of heart disease down the line.
Scott Webb: Yeah, I think you're absolutely right. So it's been really educational today. Doctor, as we wrap up, what would be your takeaways when we think about the vague symptoms of heart disease? What do you most want folks to know?
Dr. Abigail Qin-Nelson: Just to remember that if these symptoms persist despite rest and treatment for what you may think are other causes for these symptoms, please go to see your doctor soon, because we do want to address and prevent development of heart disease early, rather than waiting for something such as a full-blown heart attack to occur.
Scott Webb: Yeah, there's no doubt, right? Reaching out, early screening, diagnosis, panels, conversations, and so on versus having to call 911, and it being an emergency-type situation. So doctor, thanks so much for your time and expertise today and you stay well.
Dr. Abigail Qin-Nelson: Thank you. You too.
Scott Webb: And visit franciscanhealth.org/heartcare to learn more. And if you found this podcast to be helpful, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next time.
Scott Webb: Sometimes the symptoms of heart disease are obvious and sometimes they are sneaky. For example, extreme tiredness, nausea, pain and swelling, stress, and anxiety may be the signs of heart disease. And here to help us understand the common and less common signs of heart disease and the importance of knowing our numbers is Dr. Abigail Nelson. She's a cardiologist with Franciscan Health.
This is the Franciscan Health Doc Pod. I'm Scott Webb. Dr. Nelson, the symptoms of heart disease are often not that obvious, right? So we're going to kind of talk about that today, the less obvious signs and symptoms of heart disease. And as we get rolling here, and maybe you can just sort of take us through, since we know that cardiac issues, as I'm saying, don't always present in the most obvious ways, what are some things that we should be on the lookout for, signs and symptoms and so on?
Dr. Abigail Qin-Nelson: You're correct. Not all cardiac symptoms are the obvious crushing chest pain that you typically see on television. A lot of times patient can have very vague symptoms such as unexplained fatigue, exhaustion, shortness of breath or even things like nausea and indigestion.
Scott Webb: Yeah. And I think that that's one of the most concerning things about cardiac issues, heart disease is just that, so many of these things, you say fatigue and exhaustion, maybe that's something else, maybe you're not sleeping well, maybe you have sleep apnea, maybe you're still recovering from COVID, right? So maybe you can just sort of tell us, you know, like when should we be concerned about our overall health? But if we're experiencing things like fatigue and exhaustion, how do we know that that's a heart issue and not something else?
Dr. Abigail Qin-Nelson: These vague symptoms definitely can be result of restricted blood flow to the heart caused by blockages. And these symptoms typically will be worse with activity or exacerbated by anxiety or stress. Now, if these symptoms continue to recur and persist without improvement, then patients should definitely concern visiting their doctors for further evaluation and not just to brush them aside and continue to ignore them. As you said, a lot of risk factors are involved such as sleep apnea, family history, smoking, high cholesterol. So being aware of potential risk factors that, you know, patient could have, putting them at higher risk is also very important.
Scott Webb: Yeah, it definitely is. And you mentioned risk factors. So let's talk about that. The risk factors are sort of complicating conditions, right? So yeah, we know that family history, genetics play a role in a lot of the conditions that people suffer, but also things that we do to ourselves and behavior, lifestyle, whether that's smoking, untreated high cholesterol, diabetes, high blood pressure, and so on. So maybe you can talk about that a little bit, the things that we tend to not go to the doctor for that we should, things that aren't being treated, and just generally how we may be contributing to our heart conditions.
Dr. Abigail Qin-Nelson: As you mentioned, family history is something that most people are well aware of. However, things like high blood pressure, high cholesterol, smoking, inactivity, not exercising, being overweight, age, diabetes, and even sleep apnea can definitely put you at risk for developing heart disease at various times.
The most important things to understand is your numbers, as they say. Be well aware of your blood sugar numbers, blood pressure, total cholesterol and BMI. So things that you look for, you want your blood pressure goal to be less than 120/80. You want your blood sugar to be less than 100. You would like your total cholesterol to be less than 200 and BMI to be between 18 and 25. So things that you can do at home to kind of improve your own health would be to schedule regular exercise, watch the weight, be mindful of eating habits. If you're not getting adequate sleep, to be aware of that and perhaps seek help early to make sure you're not missing sleep. Continuing to be aware of your goal number, so that you can work with your physician to achieve these goals through treatment or lifestyle modification.
Scott Webb: Yeah, and we've heard, and I've definitely heard hosting podcasts that, you know, folks during COVID have been delaying healthcare. We know that time is heart, time is brain when we think about, heart conditions, heart attacks, strokes, and so on. Has that been your experience through COVID? And do you see more folks coming into the office now? Do we feel like we've kind of turned the corner a little bit and folks are back to maybe taking care of themselves a little better?
Dr. Abigail Qin-Nelson: Yes, absolutely. COVID has definitely played a very unique role in patients' health, whether you've had it or are just very cautious in avoiding public places to decrease your chance of catching COVID. It has definitely put a delay in a lot of patient's eagerness to seek healthcare for these vague symptoms. And now that things are coming down a little, we are seeing more patients returning to the office with questions and concerns. And I think it's very important that things don't get ignored due to fear. Yes, while COVID risk is concerning, so is risk of heart disease and untreated heart disease. We would rather see you in the office and address these symptoms and treatment for these symptoms in a very stable, controlled environment instead of seeing a patient for the first time when they're coming in with a full blown heart attack.
And on top of that, patients who've had COVID have also developed very unique, vague symptoms that are related to just recovery from COVID itself. And sometimes they're very difficult to distinguish between whether these are heart-related or COVID-related. So again, more important for patients to seek help early so that we can help them on their way to recovery, whether it's due to their heart or long-haul COVID symptoms.
Scott Webb: Yeah. And we've done a podcast on long haulers, and there's no doubt that it's challenging for all of us to know. Is this like residual effects from COVID or do I actually have heart disease or maybe it's both? And as you say, early screening and diagnosis is so key in almost all cases, but especially when we talk about heart disease. And along those lines, let's talk about the difference in presentation between men and women. Not only do heart disease symptoms present differently, but also how men and women may perceive their symptoms differently.
Dr. Abigail Qin-Nelson: That is correct. Men and women can have very unique presentation of heart disease. Men typically will have more common symptoms such as breaking out in a cold sweat, pain in their left arm, and indigestion. On the other hand, women typically will feel discomfort between the shoulder blades or have sleep disturbances. And again, these symptoms are very easily brushed off as something that's just, you know, stress-related or muscle-related. And oftentimes, women are busy taking care of other people and these symptoms are easily ignored. And so there can be delay in recognition and treatment due to this. So I think everyone should be cognizant of these symptoms and if they continue to persist, know that it is not something that should be ignored and should seek further evaluation sooner rather than later.
Scott Webb: Yeah, I think you're so right. As said, you've used the word today, vague, these vague symptoms, right? And it's so easy for so many of us to sort of brush things off as, "Oh, well, you know, I've got this pain between my shoulder blades, but I did lift that box earlier. So I probably just pulled a muscle," and you may have, but as you've identified today and stated, you know, if these signs and symptoms persist well beyond what would have been a pulled muscle or something like that, that's a great time to reach out to our doctors, right?
Dr. Abigail Qin-Nelson: Correct. Absolutely.
Scott Webb: Yeah. And you mentioned earlier about knowing our numbers. And maybe you can just sort of take us through that. When we say know your numbers, what does that mean exactly?
Dr. Abigail Qin-Nelson: As mentioned, some of the key numbers that you should be aware of and pay attention to are blood pressure, blood sugar, total cholesterol and BMI. Of course, there are various panels that are done during these routine tests that, you know, also play important role. But if you keep these numbers in mind, they will give you a good starting point to know what to bring up with your physician.
So your blood pressure goal should be less than 120/80. Your blood sugar goal should be less than 100. Your total cholesterol goal should be less than 200. And your BMI should be between 18 and 25. Now, when you see that your numbers are higher than these goal numbers, it is definitely a platform for you to have an in depth discussion with your physician on treatment options that can help lower these in addition to medications, which I know a lot of people can be resistant to in the beginning, but there are a lot of things you can do through diet, exercise that can help achieve your goals without medication if that is what you prefer in the beginning. But being mindful and being active in your care will help kind of get you to these goals early and prevent development of heart disease down the line.
Scott Webb: Yeah, I think you're absolutely right. So it's been really educational today. Doctor, as we wrap up, what would be your takeaways when we think about the vague symptoms of heart disease? What do you most want folks to know?
Dr. Abigail Qin-Nelson: Just to remember that if these symptoms persist despite rest and treatment for what you may think are other causes for these symptoms, please go to see your doctor soon, because we do want to address and prevent development of heart disease early, rather than waiting for something such as a full-blown heart attack to occur.
Scott Webb: Yeah, there's no doubt, right? Reaching out, early screening, diagnosis, panels, conversations, and so on versus having to call 911, and it being an emergency-type situation. So doctor, thanks so much for your time and expertise today and you stay well.
Dr. Abigail Qin-Nelson: Thank you. You too.
Scott Webb: And visit franciscanhealth.org/heartcare to learn more. And if you found this podcast to be helpful, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next time.