American Heart Month marks a clear opportunity to do a little self-examination -- of your body, your diet and your lifestyle. Heart disease is the most common cause of death for Americans, so if your heart isn't working right, we don't need to explain why that's a really bad sign.

There are things you can watch out for, if you're concerned about the health of your ticker (and you should be, regardless of your age or health). We've put together a series of nine items you could think of as clues or warnings that you might need to make a change:

Shortness of Breath

Shortness of breath, especially coupled with chest pains, torso pain or increased heart rate, can be a strong indicator of a heart attack. Shortness of breath can also be a sign that you’re headed for heart trouble, even if you aren’t having a heart attack. If your heart isn’t working properly, blood flow gets backed up in your pulmonary veins and fluid will leak into your lungs. If it doesn’t take much to get you winded, it could be some form of heart failure and you should consult your doctor. If you are at rest and you are suddenly short of breath for a long time, or it gets increasingly worse, you could be having a heart attack and you need immediate medical attention. Also, if it’s a sign of heart problems, shortness of breath will wake you up while you’re sleeping. A related issue can also be persistent and severe coughing, especially if it also produces blood-tinged mucus. If either of these are happening, you need to visit your doctor.

Fatigue

Unexplained and increasing fatigue or tiredness is one of the more subtle symptoms of a heart problem. If you’re suddenly feeling more tired all the time or having difficulty with everyday activities you’re used to doing, or especially if even modest physical exertion wears you out quickly, it could be a sign of heart failure. This means your heart isn’t able to properly control the flow of blood. A person with heart failure feels more fatigued because her heart can’t pump enough blood to meet the needs of other organs and tissues in the body. When vital organs aren’t getting enough blood, your body will divert the blood from muscles in the limbs and send it to the heart and brain to keep them functioning. If you’ve had prolonged, unexplained fatigue, your doctor can do tests to make sure your heart is functioning properly.

Dizziness, Fainting, Lightheadedness

Similar to fatigue, dizziness, fainting and lightheadedness are more subtle signs of potentially dangerous heart issues. For example, if you feel dizzy or lightheaded during heavy or even moderate physical activity, it could be a sign that your heart cannot keep up and pump enough blood where it’s needed. Feeling faint, lightheaded or dizzy, particularly when experiencing other heart trouble symptoms, could be due to reduced blood flow to the brain. If the blood flow to the brain is severely reduced, you could have a sudden loss of consciousness. These are serious symptoms and could signify issues with an abnormal heart rate or with your heart’s ability to pump blood. You could be at risk for a heart attack or a stroke.

Chest Pain

Chest pain is one of the more common and obvious warnings of either a heart attack or heart failure. Chest pain is a serious symptom of a heart problem, as most heart attacks involve prolonged discomfort in the center of the chest. It is usually described as “uncomfortable pressure, squeezing, fullness, burning, aching or pain.” Chest pain can be an early warning of a heart issue, but if it is severe, lasts more than a few minutes, and/or radiates to other areas of your torso or down your arm, you need immediate medical attention. Experts say that chest pain should always be treated as serious, because it can indicate that you have worsening heart failure or a heart attack.

If you experience chest pain, stop what you’re doing and lie down. If it lasts for more than 15 minutes, you should call 911. Experts also say that calling for an ambulance is your best bet, rather than having someone drive you, because emergency workers can start working to save your life immediately and you’re likely to get admitted into the hospital faster.

Other Body Pain

Heart attacks and heart failure don’t just present themselves with pain in the chest or heart. Often, other parts of your body will feel pain. For one thing, you might notice that your extremities get that tingling “pins and needles pain” more often if your heart isn’t pumping enough blood through your body, which can be an early warning of heart failure. Pain in other parts of your body can also be a signal of a heart attack. Women especially report other “indigestion”-type pain, rather than severe chest pains, when having a heart attack. These pain symptoms could be felt throughout your torso, as discomfort in one or both of your arms, and in your shoulders, back, neck, jaw or stomach. The pain might feel like pressure on one of these body parts, or like a radiating discomfort going from one body part to another. These pain symptoms should not be ignored.

Arrhythmia

Arrhythmia is an irregular rhythm in your heartbeat that is often described as a fluttering of the heart or your heart missing a beat. Most of the time arrhythmias are harmless, but sometimes they can signal that something is wrong with your heart. This is especially true if you have an arrhythmia that coincides with other, more serious heart problem symptoms. If you find that you have a persistent arrhythmia, paired with other symptoms, you should visit your doctor to rule out any major issues. Keep in mind that some arrhythmias can put you at risk for a stroke, so don’t leave this issue unchecked.

Digestion Issues

Not every digestive problem can be attributed to a heart issue, but changes in your digestion or appetite can be an indicator of heart failure. And your digestion can be a warning sign for an impending heart attack if you’re experiencing terrible heartburn with nausea and vomiting. When your heart isn’t working properly, your stomach and other digestive organs don’t receive enough blood, which interrupts the digestion process. You could feel full after only a small amount of food or feel nausea after you eat because your stomach doesn’t have the blood it needs to digest your food.

Also, if your heart isn’t pumping enough blood and fluid is getting built up in your lungs, they will swell and cause pressure on your digestive system, resulting in a feeling of fullness or nausea. If you’ve had heart problems in the past, or you have other symptoms, these digestive issues could be a clue that you’re on the road to heart trouble.

Weight Gain, Fluid Buildup

A subtle, less well-known symptom of an underlying heart problem is rapid weight gain or a fluid buildup in different areas of your body. This could be swelling or bloating in your stomach or waist, or it could appear as swelling in the feet, ankles or legs. What happens is that when your heart isn’t pumping as much blood, the blood that is returning to the heart through your veins gets backed up. When that fluid is backed up, more fluid will build up in your tissues. Also, your kidneys can’t get rid of sodium and water as quickly because they aren’t receiving enough blood, so you will retain more fluids. You may notice quick fluctuations in your weight from day-to-day as fluid is accumulated and then released. If this is happening, more importantly if there are other symptoms as well, you should see your doctor.

Lifestyle

The final hint that you may be headed for heart trouble doesn’t come from your heart. It’s your lifestyle. There are several factors and lifestyle choices that put you at increased risk for a heart attack, most of which are preventable. A sedentary lifestyle (which means you get no exercise), smoking and obesity are three of the five major risk factors for heart disease. These risk factors are entirely preventable by changes in how you live. Even small changes can improve your health and greatly reduce your risk of a heart attack or heart failure.

The other two major risks are high blood pressure and abnormal values for blood lipids. These aren’t always caused by lifestyle choices, but even eating a healthy diet and having regular checkups with your doctor can reduce those risks, which is entirely up to you.

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