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Heart Disease: Symptoms, Causes, and Risk Factors Explained

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Heart Disease: Symptoms, Causes, and Risk Factors Explained

Often, heart disease develops silently. Yet it remains the leading cause of death worldwide.

According to the Australian Institute of Health and Welfare (AIHW), cardiovascular disease claims one Australian life every 12 minutes. Still, many people do not recognise the warning signs until it is too late. That delay can have serious consequences.

The good news? Heart disease is largely preventable. You just need to understand what it is, how it develops, and what puts you at risk. That knowledge is the first step toward protecting your health.

GoldCare Medical Centre in Dandenong has experienced GPs who see patients with cardiovascular risk factors every day. This guide breaks down what you need to know.

Symptoms of Heart Disease

Symptoms vary depending on the type of heart disease and how far it has progressed. Some people have no symptoms at all until a major event, such as a heart attack, occurs. This is why regular health checks matter so much.

Coronary Artery Disease

Chest pain, tightness, or discomfort (known as angina)
Shortness of breath
Pain or discomfort that radiates to the arm, shoulder, jaw, neck, or back
Fatigue, particularly with physical activity
Dizziness or light-headedness

Heart Arrhythmias

Fluttering or pounding sensation in the chest (palpitations)
A racing or slow heartbeat
Chest pain
Dizziness or fainting
Shortness of breath

Heart Failure

Persistent shortness of breath, especially when lying flat
Swelling in the legs, ankles, or feet (oedema)
Rapid weight gain due to fluid retention
Fatigue and weakness
Persistent cough or wheezing

Heart Valve Disease

Shortness of breath
Fatigue
Swollen feet or ankles
Chest pain
Fainting or dizziness

Common Warning Signs to Stay Aware

Here we explain some common signs you shouldn’t ignore.

Chest pain or discomfort

Chest pain is one of the most recognised symptoms of heart disease. Doctors often call it angina. You may feel pressure, tightness, heaviness, or burning in the chest. The pain can spread to the arms, shoulders, neck, jaw, or back. It often appears during physical activity or emotional stress and improves with rest.

Shortness of breath

Breathlessness may occur during activity or even while resting. It happens when the heart cannot pump blood efficiently. Fluid may build up in the lungs, making breathing difficult. Many people dismiss this symptom as poor fitness, but persistent shortness of breath needs medical review.

Fatigue

Ongoing tiredness can signal reduced blood flow. When the heart struggles to circulate oxygen-rich blood, the body feels drained. Every day tasks may suddenly feel exhausting. Unexplained fatigue is particularly common in women with heart disease.

Irregular heartbeat

You may notice a racing, fluttering, or pounding sensation in your chest. These palpitations can point to arrhythmia. While occasional skipped beats are common, frequent or prolonged irregular rhythms require medical attention.

Swelling in the legs, ankles, or feet

Fluid retention often suggests the heart is not pumping effectively. This symptom appears in conditions such as heart failure. Shoes may feel tighter, and you may notice swelling that worsens by the end of the day.

Dizziness or fainting

Reduced blood flow to the brain can cause lightheadedness or blackouts. This may link to abnormal heart rhythms or structural heart problems. Sudden fainting should never be ignored.

Symptoms in Women

Heart disease symptoms in women can differ from the classic chest pain pattern. Many women experience subtler signs, which can delay diagnosis.

Shortness of breath without severe chest pain
Nausea or indigestion-like discomfort
Pain in the jaw, neck, shoulder, or upper back
Unusual or extreme fatigue
Lightheadedness

Causes of Heart Disease

Heart disease rarely has a single cause. In most cases, several factors damage the heart and blood vessels slowly and silently.

The most common cause is the narrowing or blockage of the coronary arteries. This process is known as atherosclerosis. It reduces blood flow to the heart muscle and increases the risk of a heart attack.

Coronary Artery Disease

CAD develops when fatty deposits (plaque) build up inside the arteries, a process called atherosclerosis. Plaque is made up of cholesterol, fatty substances, cellular waste, calcium, and fibrin. As the plaque grows, it hardens and narrows the arteries, restricting blood flow to the heart.

If a plaque ruptures, it can trigger a blood clot that completely blocks the artery, causing a heart attack.

Heart Arrhythmias

Arrhythmias can result from:

Coronary artery disease or prior heart attack (which damages electrical pathways)
High blood pressure
Diabetes
Smoking and excessive alcohol use
Stress
Certain medications or supplements
Structural changes to the heart from other conditions

Heart Failure

Heart failure typically develops after the heart has been damaged or weakened by another condition, most commonly coronary artery disease, a previous heart attack, high blood pressure, or cardiomyopathy.

Congenital Heart Defects

These form during foetal development, often in the first six weeks of pregnancy. Some are linked to genetic conditions such as Down syndrome, or to certain medications, infections, or substance use during pregnancy.

Cardiomyopathy

Causes include long-term high blood pressure, heart valve problems, chronic excessive alcohol use, and certain infections. In some cases, no identifiable cause is found.

High Blood Pressure

High blood pressure, also called hypertension, damages artery walls over time. The constant force of blood flow weakens and scars the inner lining. This damage makes it easier for plaque to form.

When blood pressure remains uncontrolled, the heart muscle thickens. Eventually, it becomes less effective at pumping blood. This strain can lead to heart failure.

High Cholesterol

Cholesterol plays a central role in heart disease. Low-density lipoprotein, often called bad cholesterol, contributes to plaque formation. High levels increase the risk of blocked arteries.

Many people have high cholesterol without symptoms. A simple blood test can detect it early.

Diabetes

Diabetes significantly increases the risk of cardiovascular disease. High blood sugar damages blood vessels and nerves that control the heart. People with diabetes are more likely to develop coronary artery disease and stroke.

When diabetes combines with high blood pressure or high cholesterol, the risk rises sharply.

Smoking

Smoking harms nearly every part of the cardiovascular system. Chemicals in tobacco damage the lining of the arteries. They reduce oxygen in the blood and raise blood pressure.

Smokers face a much higher risk of heart attack, stroke, and peripheral artery disease. Even secondhand smoke increases risk.

Obesity and Physical Inactivity

Excess body weight forces the heart to work harder. Obesity is often linked to high blood pressure, high cholesterol, and insulin resistance.

Lack of physical activity weakens the heart muscle and reduces circulation efficiency. Regular exercise strengthens the heart and improves overall cardiovascular health.

Chronic Stress

Long-term stress affects heart health more than many people realise. Stress hormones raise blood pressure and heart rate. They also encourage unhealthy coping behaviours such as overeating or smoking.

Inflammation

Chronic inflammation may contribute to artery damage and plaque formation. Certain autoimmune conditions and long-term infections can increase inflammation levels in the body.

Researchers continue to study how inflammation contributes to cardiovascular disease progression.

Risk Factors for Heart Disease

Risk factors fall into two categories: those you cannot change, and those you can. Managing the modifiable ones significantly reduces your risk.

Non-Modifiable Risk Factors

Age: The risk of heart disease increases with age. Men aged over 45 and women aged over 55 face a higher risk.

Sex: Men develop heart disease earlier than women on average. However, women’s risk increases significantly after menopause.

Family history: If a first-degree relative (parent or sibling) had heart disease before the age of 55 (men) or 65 (women), your risk is higher.

Ethnicity: Some populations, including South Asian and Aboriginal and Torres Strait Islander peoples, face a disproportionately higher risk of heart disease.

Modifiable Risk Factors

High blood pressure (hypertension): Persistently high blood pressure damages arterial walls and forces the heart to work harder. It is one of the most powerful risk factors for heart disease. In Australia, approximately 1 in 3 adults has high blood pressure, and many do not know it.

High cholesterol: Elevated LDL (low-density lipoprotein) cholesterol contributes directly to plaque build-up in the arteries. A blood test is the only way to check your cholesterol levels.

Diabetes: High blood sugar levels damage blood vessels and nerves over time. People with type 2 diabetes have two to four times the risk of developing heart disease compared to those without diabetes.

Smoking: Tobacco smoke damages the lining of arteries, raises blood pressure, reduces oxygen in the blood, and accelerates atherosclerosis. Smoking doubles the risk of heart disease.

Obesity: Excess body weight, particularly abdominal fat raises blood pressure, cholesterol, and the risk of developing type 2 diabetes, all of which increase cardiovascular risk. In Australia, two-thirds of adults are overweight or obese.

Physical inactivity: A sedentary lifestyle weakens the heart and contributes to obesity, high blood pressure, and poor cholesterol levels. The Australian Physical Activity Guidelines recommend at least 150 minutes of moderate activity per week.

Unhealthy diet: A diet high in saturated fats, trans fats, salt, and refined sugars promotes high cholesterol and high blood pressure. Diets rich in vegetables, fruits, whole grains, lean proteins, and healthy fats are associated with significantly lower cardiovascular risk.

Excessive alcohol consumption: Heavy drinking raises blood pressure, causes arrhythmias, and weakens the heart muscle. Australian guidelines recommend no more than 10 standard drinks per week and no more than 4 on any single day.

Chronic stress: Ongoing stress raises blood pressure and encourages unhealthy behaviours such as smoking, overeating, and physical inactivity, all of which raise heart disease risk.

Sleep apnoea: Untreated sleep apnoea causes repeated drops in blood oxygen levels during sleep, placing significant strain on the cardiovascular system.

How Is Heart Disease Diagnosed?

Your GP plays a central role in identifying your cardiovascular risk early. Early detection gives you and your doctor the best chance to prevent progression through lifestyle changes, medication, or referral to a specialist.

GoldCare Medical Centre provides a heart health assessment that include:

Blood pressure check
Blood tests to measure cholesterol, blood sugar, and other markers
BMI and waist circumference measurement
Electrocardiogram (ECG) to check heart rhythm
The cardiovascular risk score is a calculated estimate of your 5 or 10-year risk of a heart attack or stroke based on multiple factors

What You Can Do Right Now

Heart disease is a gradual process, and that gives you time to act early.

You should stop smoking right now. This is the single most impactful change most smokers can make. Ask your GP about cessation support and the Quitline.
You can do physical exercise daily at least for 30 minutes of moderate activity on most days. Walking is also the best exercise for a healthy lifestyle.
Make some changes in your diet routine, such as reducing salt, saturated fat, and processed foods. Add more vegetables, legumes, wholegrains, and fish to your diet.
Manage your weight. Even modest weight loss of 5–10% can meaningfully reduce blood pressure and cholesterol.
Limit alcohol consumption and stay within Australian guidelines.
Manage stress with Prioritise sleep, connection, and activities that genuinely help you decompress.
As age increases, get your blood pressure, cholesterol, and blood sugar checked regularly, especially if you are over 45, or over 30 if you are of Aboriginal or Torres Strait Islander descent.