Ask the Expert: What Are the Early Signs of Heart Disease?

Beauty and health

Heart disease is the leading cause of death for people in the United States, according the Centers for Disease Control (CDC), and African-Americans have the highest overall death rate from heart disease of any ethnic group in the U.S. – particularly out-of-hospital deaths – and at younger ages.

Delano R. Small, M.D., the Chief of Cardiology at Ascension Providence Hospital’s Southfield and Novi campuses, says the term “heart disease” refers to several types of heart conditions. In the United States, coronary artery disease is the most common type of heart disease, which affects the blood flow to the heart and can cause a heart attack. 

Dr. Small uses the term “coronary vascular disease” to encompass many conditions, including heart attacks, strokes, irregular heartbeat and high blood pressure, to name a few. Being monitored for heart disease is important, particularly if you have a family history. “Seek advice sooner rather than later,” Dr. Small says.  

Identification of high-risk individuals for treatment, especially control of hypertension and diabetes, is critical – particularly in the African-American community where the survival rates of patients with heart disease is significantly lower than the survival rates of Hispanic and Caucasian patients. 

“As a community, African-Americans have higher rates of high blood pressure, high cholesterol, obesity and diabetes – the four major risk factors for heart disease,” Dr. Small says. However, African-Americans tend to put off seeking treatment. 


“We have not been able to make a good dent in screening as with other groups,” he says, noting that one of the early warning signs for developing heart disease, Type 2 diabetes, is showing up earlier. Type 2 diabetes presents a major risk for kidney disease, which in turn, increases the risk of dialysis, and also increases the potential for developing heart disease.

The CDC reports about 47 percent of sudden heart deaths occur outside a hospital, which means that many people with heart disease don’t act on early warning signs. Earlier symptoms such as shortness of breath, or not being able to do things as easily as before are “a warning to see someone.”

“Once you go into chest pain, that signals a problem that needs to be addressed immediately,” Dr. Small says. People with diabetes may not experience chest pain and may only report shortness of breath as a symptom of a heart problem. Women often have different symptoms of heart disease than men. Where men may have the typical “elephant sitting on the chest” complaint, women may describe “squeezing, tightness, pressure and pain in the arm and back along with sweating,” Dr. Small says. 

Anyone experiencing symptoms of chest pain or pressure that doesn’t go away, or anyone having trouble breathing, should call 911. “Don’t try to drive yourself to the hospital,” he urges. Aside from regular checkups, controlling high blood pressure and diabetes, along with engaging in more physical activity can help decrease the risk of developing heart disease.  

Get more health information and find a doctor near you by visiting or calling 866-501-DOCS (3627)

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