American Heart Month: Recognizing when to speak with your doctor

Written by Dr. Omar Batal, cardiologist at IU Health West

Heart disease is a leading cause of death, yet many individuals are unsure when to address concerns about their cardiovascular health. Recognizing the signs of potential heart problems and consulting your primary care physician (PCP) promptly can make a significant difference in preventing or managing heart disease. Your PCP plays a vital role in evaluating symptoms, determining risk factors and, when necessary, referring you to a cardiologist for specialized care.

Why Early Action Matters

Heart disease is often silent in its early stages, but certain symptoms and risk factors can serve as warning signs. Acting on these early clues by consulting your PCP allows for timely testing, diagnosis and intervention.

Symptoms You Shouldn’t Ignore

Certain signs and symptoms should prompt an immediate visit to your PCP. These include:

• Chest Pain or Discomfort: Any sensation of pressure, tightness or pain in the chest, particularly during physical activity or stress, could indicate angina, a sign of coronary artery disease.

• Shortness of Breath: If you find yourself struggling to breathe during routine activities or when lying down, it may signal heart failure or other cardiovascular issues.

• Heart Palpitations: Irregular, racing, or skipped heartbeats can be benign, but they may also point to arrhythmias requiring further evaluation.

• Swelling in the Legs, Ankles or Feet: Fluid retention in the lower extremities can indicate heart failure or poor circulation.

• Dizziness or Fainting: These could result from issues like low blood pressure, arrhythmias or structural heart problems.

If you experience any of these symptoms, do not wait—consult your PCP as soon as possible. They can perform an initial assessment and decide if cardiology care is needed. However, if symptoms are abrupt or sudden onset, severe in intensity, prolonged (such as lasting more than 15 min or recur after appearing to resolve) or outside your comfort level to wait, you should call 911 or go directly to the Emergency Department for prompt evaluation and care.

Risk Factors That Warrant Attention

Even in the absence of symptoms, certain risk factors make it essential to stay vigilant about your heart health. These include:

• Family History: If heart disease is prevalent in your family, especially if relatives were diagnosed at a young age, your PCP should be informed.

• Chronic Conditions: Conditions like high blood pressure, high cholesterol or diabetes significantly increase your risk of heart disease. Regular monitoring and management by your PCP are crucial.

• Lifestyle Choices: Smoking, a sedentary lifestyle and an unhealthy diet all contribute to cardiovascular problems. Your PCP can guide you toward healthier habits and refer you to resources for support.

The Role of Your Primary Care Physician

Your PCP is your first line of defense against heart disease. They are well-equipped to evaluate your symptoms and risk factors, order initial tests, and provide guidance on managing your heart health. Common steps your PCP might take include:

• Conducting a physical exam and reviewing your medical history.

• Ordering blood tests to assess cholesterol levels and other markers.

• Performing or recommending tests like coronary calcium score (heart scan) to better determine your future risk for cardiac events, electrocardiograms (ECG) or heart monitor to check your heart’s rhythm, imaging studies like an echocardiogram to evaluate heart function or stress testing to evaluate for underlying coronary artery disease.

If your PCP identifies concerns or suspects a more serious condition, they will refer you to a cardiologist for further evaluation and specialized care.

When to See a Cardiologist

Referral to a cardiologist is often appropriate when:

• You have persistent or severe symptoms such as chest pain or shortness of breath.

• Initial tests suggest a potential heart condition.

• You require advanced testing or a cardiac procedure, such as a stress test or cardiac catheterization.

• You have complex risk factors, like a combination of diabetes and hypertension, that need specialized management.

Recognizing the signs of potential heart problems and seeking care promptly can prevent serious complications and improve your quality of life. To learn more about heart health, visit iuhealth.org/heart.