This Is the No.1 Sign of Heart Disease in Men

HEART DISEASE IS the No. 1 cause of death for men (and women) in the U.S.—but not everyone knows that.

A 2024 American Heart Association and Harris Poll survey found that 51 percent of Americans couldn’t identify heart disease as the leading cause of death for adults. But more lives were claimed by heart disease and stroke in 2021 than all forms of cancer and chronic lower respiratory disease.

Almost half of adults have some kind of cardiovascular disease, including coronary heart disease, heart failure, stroke, or high blood pressure. And they often don’t know it. That’s why doctors say it’s crucial to recognize your risk factors and the signs of heart disease.

“Prevention is the most important word in cardiology,” says Vignesh Raghunath, M.D., a cardiologist at Atlantic Health System who specializes in non-invasive cardiology. “You don’t want to miss the boat on identifying problems early that could prevent a heart attack or stroke later in life.”

Too often, men feel tempted to “push through discomfort or assume symptoms aren’t serious,” says Richard Dal Col, M.D., M.P.H., president of MVP Health Care. Paying attention to the signs of heart disease and seeking early treatment can be a life-saver. Here’s what to know.

The No. 1 Sign of Heart Disease in Men

THE BIGGEST WARNING sign is one you might expect: chest pain.

It may not feel exactly like pain, though. It could be more of a tightness or squeezing in your chest (or it could feel like outright pain), says Ethan Korngold, M.D., chief medical officer at Abbott‘s vascular business.

The feeling may radiate to your arm, neck, back, or jaw, Dr. Dal Col says. It can happen while you’re resting or during an activity.

“It’s important to note that the sensation isn’t always sharp pain—it can feel like a dull, persistent ache,” he notes.

Any time you feel pain, tightness, or pressure in your chest, call 911 immediately.

Other Signs of Heart Disease

ALONG WITH CHEST pain or discomfort, there are several other less-expected symptoms that could signal heart disease. Here are some things to pay attention to:

Shortness of Breath

WHEN YOUR HEART can’t pump properly, it has to work harder. Blood can back up into the veins connecting the heart and lungs, causing fluid to leak into the lungs and creating shortness of breath, according to Mount Sinai.

Dr. Raghunath compares it to a car engine: “You may not notice a problem at 25 mph, but it may be more apparent at 60 mph, as the engine struggles to keep up.”

You might notice shortness of breath while you’re resting, lying flat, or during physical activity.

Erectile dysfunction

ERECTILE DYSFUNCTION MIGHT be an early warning sign of a heart problem, Dr. Raghunath says. It can suggest a problem in the heart or blood vessels that reduces blood flow through the body.

Research suggests that ED is associated with a two-fold increase in heart attack, stroke, and death from a cardiovascular event. It’s also suggested that ED can occur years before a man experiences heart problems.

If you’re struggling with ED, see your doctor. Addressing the problem will improve your sex life and lower your risk for heart disease down the road.

Change in Exercise Capacity

IF YOU SUDDENLY notice that you’re struggling through your usual workout, it could be evidence of heart disease or an impending heart attack, Dr. Korngold says.

“I saw a patient who is a marathon runner, but he was concerned about a sudden worsening of his mile times and a major change in his ability to exercise,” he says. A stress test revealed the patient had a blockage in his heart, which was treated by placing a stent in one of the main arteries of the heart. The patient was then able to return to his normal activity level.

Leg Pain or Swelling

NOTICING PAIN OR swelling in your legs could also suggest that your blood isn’t able to flow freely, and you may have a heart or blood vessel problem, Dr. Raghunath says.

This can cause fluid to build up in your tissues and swelling in your lower legs. You might also notice tingling or numbness in your legs, feet, or hands, which could be signs of narrowing blood vessels, a risk factor for heart disease.

Fatigue

CONSTANTLY FEELING TIRED could be linked to many things. But if you’re getting plenty of sleep and usually have a high energy level, suddenly feeling run down all the time may be a sign of a heart problem. It’s especially concerning if the fatigue doesn’t get better with rest, Dr. Dal Col says.

Excessive Sweating

SWEATING PROFUSELY WHEN you haven’t been out in hot weather or had an intense gym session could be a sign of heart disease. Dr. Dal Col says this happens when the heart isn’t pumping efficiently, which impacts circulation and oxygen delivery throughout the body.

How to Know If Symptoms Are an Emergency

EVERYONE AND THEIR situation is unique, so it can sometimes be difficult for people to know if they should call 911 or just make an appointment with a cardiologist.

“I always tell patients that if they are worried enough to call me at night, it is often worth a visit to the emergency room,” Dr. Raghunath says. “This is especially important when it comes to heart concerns since we often don’t know what’s wrong without testing.”

When symptoms are severe and have happened suddenly, it’s likely an emergency, he says. Symptoms that get worse or chest pain lasting more than a few minutes, dizziness, fainting, or shortness of breath should prompt you to take immediate action and call 911, Dr. Dal Col emphsizes.

Time is crucial—the sooner you act, the more of the heart muscle physicians can preserve, and you can receive the right treatment to improve and potentially save your life, Dr. Korngold says.

Mild chest pain that’s been happening for a while or fatigue that resolves when you rest usually isn’t an emergency, but you should make an appointment with your doctor to get checked, he adds.

When should you get your heart tested?

IF YOU HAVE a family history of heart disease or other risk factors, like being overweight or a smoker, start getting routine screenings at your doctor’s office now.

In your 20s, Dr. Raghunath recommends getting your cholesterol, blood pressure, and A1C (which measures the amount of sugar in your blood) checked. In your 40s, he typically checks calcium scores, which detects calcified heart plaque.

These tests reveal if you have high cholesterol, high blood pressure, or diabetes, which are risk factors for diabetes—and Dr. Raghunath says these conditions are often underdiagnosed and under-treated.

“These tests allow physicians and patients to understand cardiovascular risk and, ultimately, create a treatment plan that is right for the individual,” Dr. Korngold says.