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What are the common misconceptions about heart disease?

person holding a toy heart symbol
a man in a white lab coat and glasses is standing in front of a building .
Kaustubh Dabhadkar, MD MPH FACC

As a cardiology trainee at Brown University, the emergency room physician called me around 2 AM for a patient who came in with ear-pain. I was already caring for multiple sick patients with life-threatening conditions in the Rhode Island Hospital cardiac care unit (CCU). So I was a little upset about being called for someone with ear pain. However, I was stunned when I looked at the person's EKG. It was a 49 year old Asian male with severe ear pain. But the EKG revealed possible 100 % blockage in one of the arteries supplying blood to his heart. 

I alerted my supervising interventional cardiologist and we performed an emergency heart catheterization. Heart catheterization is the procedure when you insert small tubes through artery to study the blood supply to the heart. As we suspected, the person had a 100 % blockage in his left circumflex artery. As soon as we opened the blockage, his ear pain resolved. As a trainee, it was an important lesson for me! Heart attack can present in a variety of ways including ear pain!! Since then, I have seen a myriad different presentations of heart-disease. But I don't think anyone can ever claim to have seen all the different symptoms of heart disease.

I want to take a few minutes to highlight the misconceptions around heart disease.


1. All Heart Attacks Have Obvious Symptoms
Not all heart attacks present with intense chest pain. Symptoms can be subtle and vary between individuals, including:

  • Shortness of breath
  • Nausea/vomiting
  • Back or jaw pain
  • Extreme fatigue
  • Severe unexplained sweating
  • And even ear pain as we see in the above case

2. Heart Disease is Only for Older People
Heart disease can affect people of all ages. Plaque buildup in arteries can begin during childhood or adolescence. Even young adults can develop cardiovascular issues, especially with increasing risk factors like obesity and diabetes.


3. Only Men Get Heart Disease
Cardiovascular disease is the leading cause of death in both men and women. While men may develop heart disease earlier, women's risk increases significantly after menopause. Women are also less likely to receive timely diagnosis or optimal treatment during heart attacks.


4. If You're Fit, You Don't Need to Worry
Being physically fit alone doesn't eliminate heart disease risk. Other factors like cholesterol, eating habits, and smoking can offset healthy habits1. Even thin people who exercise need to monitor their cardiovascular health.


5. Heart Disease is Always Hereditary
While family history increases risk, it's not a guarantee of developing heart disease. Many risk factors are controllable through lifestyle changes.

Action Steps Against Heart Disease Misconceptions

1. For Young People
Start heart health monitoring by age 20, including regular cholesterol screenings and blood pressure checks. Establish healthy eating habits early, focusing on fruits, vegetables, and whole grains while limiting processed foods.

2. For Women
Schedule regular cardiovascular screenings, especially around menopause. Learn to recognize women-specific heart attack symptoms, including unusual fatigue, jaw pain, and nausea. Create a personalized heart health plan with your healthcare provider that accounts for pregnancy and hormonal changes.


3. For Physically Active Individuals
Complement exercise with regular monitoring of key health markers. Get comprehensive health screenings that include blood pressure, cholesterol, and blood sugar levels, even if you're physically fit. Maintain a balanced diet rich in heart-healthy foods regardless of your fitness level.


4. For Those With Family History
Develop a proactive prevention plan that includes regular medical check-ups and lifestyle modifications. Focus on controllable risk factors by maintaining a healthy weight, managing stress levels, and getting adequate sleep. Track your numbers (blood pressure, cholesterol, blood sugar) more frequently than those without family history.


5. For Everyone
Learn the full spectrum of heart attack symptoms, including both typical and atypical signs. Create an emergency action plan that includes knowing your nearest cardiac care facility and keeping important medical information readily accessible. Practice stress management techniques and maintain good sleep hygiene as part of overall heart health.

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