A ‘broader definition’ of what constitutes ‘important’ symptoms of cardiovascular diseases should be considered, says the team behind new research into the most reported signs of these diseases.

A scientific statement published by the American Heart Association aims to further understanding of cardiovascular diseases by reviewing current research into the symptoms.

Researchers found that often, symptoms are different for men and women. They also highlighted how some symptoms may be experienced over months or years, across a range of severity.

The chair of the scientific statement writing committee, Associate Professor Corrine Y. Jurgens from Boston College’s Connell School of Nursing, said: “Symptoms of these cardiovascular diseases can profoundly affect quality of life, and a clear understanding of them is critical for effective diagnosis and treatment decisions. The scientific statement is a ‘state of the science’ compendium detailing the symptoms associated with CVD, similarities or differences in symptoms among the conditions, and sex differences in symptom presentation and reporting.”

Globally, cardiovascular disease is the main cause of death. The scientific statement looks at six conditions – heart attack, heart failure, valve disease, stroke, heart rhythm disorders, and peripheral artery and vein disease.

Dr Jurgens: “Some people may not consider symptoms like fatigue, sleep disturbance, weight gain and depression as important or related to cardiovascular disease. However, research indicates that subtle symptoms such as these may predict acute events and the need for hospitalisation. A broader definition of what constitutes an ‘important’ symptom is warranted.

“Establishing a baseline symptom profile for an individual and tracking symptoms over time may be helpful to detect changes and any progression of symptoms.”

With heart attacks, the most common symptom reported is chest pain, with additional symptoms including shortness of breath, sweating or a cold sweat, unusual fatigue, nausea and light-headedness.

The team highlighted the more subtle symptoms of heart failure, which may include an upset stomach, nausea, vomiting, loss of appetite, fatigue, exercise intolerance, sleep disturbances, pain, mood disturbances (notably depression and anxiety), and issues like brain fog and memory issues.

They found that women reported a wider range of symptoms, including nausea, palpitations and digestive changes, higher levels of pain in other areas of the body, swelling and sweating.

Dr Jurgens said: “Monitoring symptoms on a spectrum, versus present or not present, with reliable and valid measures may enhance clinical care by identifying more quickly those who may be at risk for poor outcomes, such as lower quality of life, hospitalisation, or death. “Ultimately, we have work to do in terms of determining who needs more frequent monitoring or intervention to avert poor heart failure outcomes.

“Symptom relief is an important part of managing cardiovascular disease. It is important to recognise that many symptoms vary in occurrence or severity over time, that women and men often experience symptoms differently, and factors such as depression and cognitive function may affect symptom detection and reporting. Monitoring and measuring symptoms with tools that appropriately account for depression and cognitive function may help to improve patient care by identifying more quickly people who may be at higher risk.”

Read the full study in the journal Circulation.

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