Doctors can usually diagnose cardiovascular disease (CVD) by observing symptoms and risk factors from the medical history and signs from the physical exam. Certain symptoms tend to be more or less common in certain conditions. For example, shortness of breath often characterizes heart failure, whereas angina is often a sign of coronary artery disease (CAD). Keep in mind that not all signs and symptoms are present for all types of CVD. Some are present only in a few conditions, others are in several different conditions, and all can be signs of many things other than CVD. And sometimes, there are no symptoms at all until the disease reaches a late stage.

Medical History

Major symptoms that point to cardiovascular conditions include:

  • Angina —The specific type and location of chest pain can tell a lot about its cause. For example, a tightness or squeezing sensation in the chest often indicates angina or heart attack. On the other hand, chest pain that gets worse when lying down and doesn’t worsen with exertion is more likely to be a symptom of pericarditis, an inflammation of the sac surrounding the heart.
  • Leg Pain Peripheral artery disease (PAD), often leads to cramping and fatigue in the legs with exertion.
  • Shortness of breath —Fluid backing up into the lungs from a failing heart leads to shortness of breath, which is often made worse by laying down. While shortness of breath is common to many types of cardiovascular conditions, it is no by no means limited to CVD. The symptom is common, for example, with lung diseases.

    Fluid in the Lungs
    Pulmonary Edema

    © Nucleus Medical Media, Inc.

  • Fatigue —Fatigue is another common symptom of CVD, presumably caused by insufficient blood flow to the muscles along with the decreased availability of oxygen due to fluid in the lungs.
  • Palpitations —A heart that is beating at an unusual force, rate, or rhythm, could just be an indication of anxiety or too much caffeine. However, abnormal heartbeats—especially if they occur in conjunction with other symptoms like fatigue or fainting—could hint at a more serious underlying condition, such as an arrhythmia.
  • Lightheadedness and Fainting —Insufficient blood flow to the brain can cause lightheadedness or fainting. This may be due to abnormal heart rate or rhythm, or to insufficient cardiac output. Of course, fainting may have many other causes ranging from anxiety to seizure disorders, and in most individuals is not due to CVD.

Physical Exam

Signs suggestive of cardiovascular conditions include:

  • Pale, clammy appearance
  • Cyanosis (blue tinge to the skin), particularly in the extremities
  • Rapid or shallow breathing
  • Rapid and/or irregular heart rate
  • High or low blood pressure
  • Swollen veins in the neck
  • Swelling in the feet and ankles
  • Abnormalities in the retina (back of the eye)
  • Enlarged heart—cardiomyopathy (measured by placing hand on chest)
  • Extra or abnormal heart sounds (via stethoscope)
  • Fluid in the lungs (via stethoscope)
  • Abnormal sounds of arterial blood flow throughout the body (via stethoscope)
  • Pulsating abdominal mass—aortic aneurysm
  • Cool extremities
  • Reduced or absent pulses in the extremities

Cardiovascular examination. Merck Manual Professional Version website. Available at: Accessed January 29, 2021.

Coronary artery disease (CAD). EBSCO DynaMed website. Available at: Accessed January 29, 2021.

Heart failure with reduced ejection fraction. EBSCO DynaMed website. Available at: Accessed January 29, 2021.

What are the signs and symptoms of coronary heart disease? National Heart, Lung, and Blood Institute website. Available at: Accessed January 29, 2021.

Last reviewed January 2021 by EBSCO Medical Review Board  Last Updated: 1/29/2021