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Tag: cough

  • Oregon Reports Record-High Pertussis Cases, Health Officials Urge Vaccination – KXL

    PORTLAND, Ore. — Oregon has recorded its highest number of pertussis cases ever, prompting state health officials to urge residents—especially those who are pregnant or spend time around infants—to ensure they are up to date on vaccinations.

    As of Dec. 10, the Oregon Health Authority (OHA) has confirmed 1,475 pertussis cases in 2025, surpassing the previous annual record of 1,420 set in 1950. The current outbreak began in spring 2024, when cases climbed to 1,252 by the end of the year. Several other states have reported similar increases.

    Infants Most at Risk

    Pertussis, or whooping cough, can cause severe illness at any age, but infants face the greatest risk of hospitalization and death. The American Academy of Pediatrics recommends that pregnant individuals receive a Tdap vaccine during the third trimester to provide newborns with protection until they can be vaccinated at two months old. Adults who will spend time around a newborn—such as partners, grandparents and caregivers—are also encouraged to get vaccinated at least two weeks before the baby’s birth.

    Vaccination remains important across all age groups. Tdap is recommended for pregnant people, children beginning at 2 months old, adolescents at 11–12, and adults who have never received a dose.

    “I worry people may not fully appreciate the risk pertussis poses as case counts are rising, especially for babies and older adults,” said Dr. Howard Chiou, medical director for communicable diseases and immunizations at OHA. He noted that maternal vaccination rates in Oregon have declined in recent years.

    Declining Immunization Rates

    According to OHA’s new Pregnancy Immunization Data dashboard, 69% of pregnant people in Oregon received a Tdap vaccine in 2024, down from 72% in 2020. Rates vary widely by county, ranging from 17% to 82%, with the lowest numbers largely in rural areas where access and vaccine hesitancy pose barriers.

    So far in 2025, Oregon has reported 87 cases of pertussis in infants under 12 months, including 22 hospitalizations. One infant in the state has died from the illness this year.

    A Post-Pandemic Surge

    Pertussis outbreaks typically occur every three to five years, but case numbers dropped sharply during the COVID-19 pandemic, when masking and social distancing limited the spread of many respiratory infections. Oregon saw just three cases in 2021, followed by 17 in 2022 and 40 in 2023. Health officials attribute the resurgence to a return to pre-pandemic behaviors combined with waning immunity and reduced vaccination rates.

    Why Vaccination Still Matters

    Studies show that Tdap vaccination during pregnancy is highly effective at preventing severe illness and hospitalization in infants. But because immunity fades over time, some residents misunderstand the need for booster doses, said Dr. Carolina Amador, Benton County’s health officer.

    “When we use the word ‘booster,’ people may think the vaccine isn’t very effective because protection fades,” Amador said. “But in the short term it does a great job protecting the most vulnerable among us.”

    The Disease and Its Diagnosis

    Pertussis spreads through respiratory droplets when an infected person coughs or sneezes. Many cases go undiagnosed because symptoms vary widely, and not everyone develops the characteristic “whooping” sound.

    Dr. Jennifer Gibbons, a naturopathic pediatrician in Portland who works with vaccine-hesitant families, said she often counsels expectant parents about the importance of maternal vaccination.

    “When parents ask me, ‘Do you think it’s right for me?’ the answer is always yes,” she said. Gibbons described whooping cough in infants as “truly awful,” and said explaining how maternal antibodies work can help parents better understand the benefits.

    OHA has posted videos of Dr. Chiou discussing the outbreak on its Media Resources page.

    Jordan Vawter

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  • Whooping cough cases on the rise: symptoms, treatment

    It’s highly infectious and definitely not a welcome Thanksgiving guest.

    Pertussis, also known as whooping cough, is on the rise with outbreaks across the country, leaving some parents of infants wondering whether they should travel or visit family at all.

    Pertussis is a bacterial respiratory infection characterized by the “whoop” sound made by sharp intakes of breath between coughing fits. Infected adults and kids can develop a brutal, weekslong cough. Sick infants are at risk of dying. 

    Vaccination offers strong protection against disease, but immunity wanes over time and Centers for Disease Control and Prevention data show fewer children are getting the vaccine. The CDC recommends adults get a Tdap booster shot every 10 years.

    Infections dropped nationally during and after the COVID-19 pandemic. In 2024, cases surged. This year, infections are similarly high. As of Nov. 19, preliminary data showed more than 25,000 cases nationwide in 2025. The states of Washington, California, Florida and Oregon have been hardest hit. 

    Heading into the holidays, what are the symptoms to watch for, who is most at risk and who needs to get vaccinated?

    Symptoms to be on the lookout for

    Whooping cough symptoms progress in stages, and the disease’s severity can depend on a person’s vaccination status.

    Symptoms usually appear within five to 10 days after exposure, but they can also take twice as long to develop. 

    During the first one to two weeks, symptoms often resemble an average cold: a mild cough, a low-grade fever and a runny nose. Although the symptoms might seem innocuous, a person is contagious during this stage.

    The second, more severe stage can last up to 10 weeks. The main symptom is intense coughing fits, called paroxysms, that can lead to vomiting. The cough ends with an intake of breath that sounds like a “whoop.”

    “Sometimes the coughing is so severe that ribs are cracked,” said Dr. Joseph Bocchini, a pediatric infectious disease doctor at Willis-Knighton Health. “There’s such shortness of breath that people wake up at night with a coughing spell, they feel like they’re suffocating.”

    Pneumonia is another possible complication. 

    People who have never been vaccinated are likely to experience worse symptoms than their vaccinated peers, Bocchini said. 

    Recovery is often gradual as the cough wanes. As a person recovers, they can be more vulnerable to contracting other respiratory infections, and the cough might return. 

    Getting sick confers natural immunity from the disease for a time, but that protection doesn’t last long.  

    Infections happen year-round, but peak whooping cough season lasts from late summer through fall. Pertussis is a cyclical disease, meaning it might spread widely through a community and then disappear from that population. Infections might return to an area once that immunity has waned.

    What causes the cough?

    The bacteria Bordetella pertussis causes the coughing. 

    The bacteria enter a person’s upper respiratory tract and latch on to cilia, hair-like extensions in the airways. Cilia are essential for clearing mucus and debris from your lungs. The bacteria release a toxin that damages the cilia and causes the airway to swell. With a person’s lung-cleaning apparatus damaged, the body resorts to coughing to get the gunk out. 

    If one person in a household is infected, data shows about 80% of exposed family members also will get infected, if they aren’t vaccinated or immune. 

    Pertussis spreads through droplets when someone sneezes or coughs. 

    How is whooping cough treated? 

    Doctors use nasal swab lab tests to identify infections. 

    Antibiotics are the most effective treatment, especially when taken early in the illness. If taken before the coughing fits begin, antibiotics can prevent the illness from progressing or make symptoms milder.

    That’s why doctors sometimes prescribe antibiotics to the infected person’s family and other contacts: to halt further spread. 

    Once the coughing fits have begun, antibiotics are less effective at reducing symptoms or shortening the course of the illness. The cilia have already been damaged, and the lungs need time to heal.

    Antibiotics are still prescribed at that stage because a five-day course kills the bacteria, making the person no longer contagious, even if the cough persists.  

    To manage symptoms, the CDC advises using a cool-mist humidifier, eating small meals to prevent vomiting and drinking plenty of fluids. The agency also recommends avoiding airway irritants such as dust, smoke or chemical fumes that might trigger coughing.

    Some pertussis cases require hospitalization. 

    Young babies are most at risk

    Whooping cough is most dangerous for babies under 1 year old, especially under 3 months. The CDC reports that 1 in 3 infected babies will need hospital treatment. About 1% of infected babies die from complications, such as pneumonia, damage in the brain or difficulty breathing.  

    Infants with pertussis sometimes don’t cough at all, but have dangerous pauses in breathing called apnea. Babies may turn blue as they struggle to breathe. 

    Older people, people who are immunocompromised and people with moderate to severe asthma also could be at higher risk of complications. 

    DTaP and Tdap vaccines can protect against illness 

    Scientists first developed a pertussis vaccine in 1914. In the 1940s, it became part of a combination vaccine that also protects against diphtheria and tetanus. It’s still combined with those today. 

    Two vaccines protect against whooping cough: DTaP, given to young children, and Tdap, given to adolescents, adults and pregnant women.

    Vaccination doesn’t stop the bacteria from entering a person’s body, but it helps stop an infection from developing. Among the minority of vaccinated people who do get sick, vaccination decreases the illness’ severity. 

    The CDC’s childhood vaccine schedule recommends that babies get their first dose of the DTaP vaccine at 2 months old. The vaccine is delivered in four more doses at 4 months, 6 months, between 15 and 18 months and between 4 and 6 years.

    “Just like we practice baseball or piano with many games of catch or lessons, providing multiple doses gives our immune system additional practice,” said Dr. Lori Handy, a pediatric infectious disease specialist at Children’s Hospital of Philadelphia. “The vaccine schedule is designed to give enough practice to our system that eventually, the person is adequately protected.”

    Vaccinated children are much less likely than unvaccinated children to get sick with pertussis. 

    During the 2024-2025 school year, 92.1% of kindergarteners received a DTaP vaccine, down from about 95% in the decade before the pandemic.

    Protection from the vaccine wanes over time, which is why we have the Tdap booster vaccine. The CDC recommended preteens get one dose, and adults get a shot every 10 years. Adults can infect children, so staying up to date is important for the little ones in your life. 

    The CDC also recommends pregnant women receive a Tdap booster between the 27th and  36th week of pregnancy, regardless of when they were last vaccinated. “Vaccination of pregnant moms provides immunity to newborn babies, so that they are protected at the time when they are most at risk of deadly disease,” Handy said. 

    How can I stay safe over the holidays? 

    “Far and away, the most important thing is to be vaccinated and be up to date,” Bocchini said. And if you have a small baby, make sure the people around the baby are also vaccinated and up to date. 

    Other strategies are basic: Wash your hands often. Use good cough etiquette. Teach these habits to your kids.

    Since the bacteria spreads through coughs and sneezes, wearing a mask can help slow the spread, whether you are infected or around someone who is. 

    If you think you might have been exposed, you can ask your doctor to test you. In its initial stage, whooping cough is hard to distinguish from other respiratory infections, Bocchini advised patients to ask themselves how they might have been exposed: Have I been around someone with a persistent cough that happens in fits? Although it may be hard, it’s safest to stay home when you are sick.

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  • A new virus variant and lagging vaccinations may mean the US is in for a severe flu season

    The United States may be heading into its second severe flu season in a row, driven by a mutated strain called subclade K that’s behind early surges in the United Kingdom, Canada and Japan.Last winter’s season was extreme, too. The U.S. had its highest rates of flu hospitalizations in nearly 15 years. At least 280 children died of influenza, the highest number since pediatric death numbers were required to be shared in 2004.Now, with a new variant in the mix, experts say we’re on track for a repeat. And with flu vaccinations down and holiday travel on the way, they worry that things may look much worse in the weeks ahead.The good news: Early analysis shows that this season’s flu shots offer some protection against being hospitalized with this variant, especially for kids. The bad news is that many Americans appear to be skipping their flu vaccines this year. New data from prescription data company IQVIA shows that vaccinations are down compared to where they usually are at this point in the year.A new playerFlu activity is low but rising quickly in the United States, according to the latest FluView report from the U.S. Centers for Disease Control and Prevention.Most of the flu viruses identified this season have been an A strain called H3N2, and half of those have come from subclade K, a variant that was responsible for a rougher-than-normal flu season this summer in the Southern Hemisphere.That variant wasn’t a major player when scientists decided which strains should be in the annual flu shots, so the vaccines cover a related but slightly different group of viruses.”It’s not like we’re expecting to get complete loss of protection for the vaccine, but perhaps we might expect a little bit of a drop-off if this is the virus that sort of dominates the season, and early indications are that’s probably going to be the case,” said Dr. Richard Webby, director of the World Health Organization Collaborating Center for studies on the ecology of influenza in animals and birds at St. Jude Children’s Research Hospital.Early analysis by the U.K. Health Security Agency shows that subclade K has seven gene changes on a key segment of the virus. Those mutations change the shape of this region, making it harder for the body’s defenses to recognize.”That’s the predominant thing that our immune system targets with antibodies, and that’s also pretty much what’s in the vaccine,” said Dr. Adam Lauring, chief of the Division of Infectious Diseases at the University of Michigan Medical School.UKHSA scientists found that the current flu vaccines are still providing decent protection against subclade K viruses. Vaccination cut the odds of an emergency department visit or hospitalization for the flu by almost 75% in children. The effectiveness for adults, even those over 65, was lower, about 30% to 40% against needing to visit the hospital or ER.But the scientists offer a caveat: These results are from early in the season, before the protection from seasonal flu vaccines has had time to wane or wear off. The findings are posted in a recent preprint study, which means it was published ahead of scrutiny from outside experts.Still, some protection is better than no protection, and while subclade K is expected to dominate the season, it won’t be the only flu strain circulating. No one gets to pick what they’re exposed to. Lauring said his daughter has just recovered from the flu, but it was a B-type strain.At the same time this new variant has emerged, flu vaccinations appear to be down in the U.S. According to IQVIA, about 64% of all flu vaccinations were administered at retail pharmacies, which administered roughly 26.5 million flu shots between August and the end of October. That’s more than 2 million fewer shots than the 28.7 million given over the same time frame in 2024.”I’m not surprised,” said Dr. Jennifer Nuzzo, who directs the Pandemic Center at Brown University’s School of Public Health. Vaccine skepticism expressed by leaders of the US Department of Health and Human Services has “injected chaos into the whole vaccination system,” she said.”There’s been a lot of attention on really non-issues,” like vaccine ingredients and separating shots, that she thinks “at the best, left people confused but possibly at the worst have left people worried about getting vaccinated,” she added.Flu vaccinations have also fallen in Australia, where subclade K was the predominant virus this year. As a result, flu hit a record, with more than 443,000 cases. Flu season in the Southern Hemisphere typically runs from May to July, so infectious disease experts often look to those countries for a preview of what might be on the way to North America.”What they saw in Australia is that they had a bad season. And so it’s concerning for you and us, what’s coming,” said Dr. Earl Rubin, director of the infectious disease division at the Montreal Children’s Hospital in Canada.’This is the time we start to see the rise’It’s difficult to say whether subclade K actually makes a person sicker than other flu strains, but if it drives more cases, it will certainly drive hospitalizations too, Rubin said.”When you look at severity, the more cases you have, if the same percentage get hospitalized, obviously you’re going to have more hospitalization if you have more cases. So it sometimes will look like the severity is also worse,” he said.Lab testing data has begun to show an uptick in flu cases.”This is the time we start to see the rise,” said Dr. Allison McMullen, a clinical microbiologist at BioMerieux, which makes the BioFire test, a popular diagnostic tool for respiratory pathogens.The company anonymously compiles its test results into a syndromic surveillance tool, which can offer a glimpse of what bugs are making people sick at any given time. At the beginning of the month, less than 1% of tests were positive for type A flu. Now it’s 2.4% – still low numbers but going up briskly, which aligns with the CDC trend.”We’re going to start seeing heavy holiday travel before we know it,” McMullen added. “With the rising cases that we’re seeing the U.K. and Japan, it can definitely be a bellwether for what we’re going to see in North America.”Signals are also rising in wastewater, said Dr. Marlene Wolfe, an assistant professor of environmental health at Emory University. In October, 18% of samples in the WastewaterSCAN network — an academically led wastewater monitoring program based at Stanford University, in partnership with Emory — were positive for type A flu, Wolfe said. In November, that number had risen to 40%.”Flu is something where, when it’s not in season, we don’t detect it very frequently in wastewater,” Wolfe said. COVID, on the other hand, can be detected pretty much all the time, which makes it challenging to know if it’s going up or down, she said.The scientists can set a threshold for when they can declare that a specific area is in flu season, Wolfe says. So far, just four of the 147 sites they monitor in 40 states have reached that threshold. Those sites are in the Northeast — in Maine and Vermont — in Iowa and in Hawaii.”I am concerned, I guess, that we could have a big flu season this year based on what we’re seeing in other parts of the world, and particularly Europe and elsewhere,” Michigan’s Lauring said.”It’s not too late. Go and get your flu shot,” Lauring advised. “And be alert that it’s out there.”

    The United States may be heading into its second severe flu season in a row, driven by a mutated strain called subclade K that’s behind early surges in the United Kingdom, Canada and Japan.

    Last winter’s season was extreme, too. The U.S. had its highest rates of flu hospitalizations in nearly 15 years. At least 280 children died of influenza, the highest number since pediatric death numbers were required to be shared in 2004.

    Now, with a new variant in the mix, experts say we’re on track for a repeat. And with flu vaccinations down and holiday travel on the way, they worry that things may look much worse in the weeks ahead.

    The good news: Early analysis shows that this season’s flu shots offer some protection against being hospitalized with this variant, especially for kids. The bad news is that many Americans appear to be skipping their flu vaccines this year. New data from prescription data company IQVIA shows that vaccinations are down compared to where they usually are at this point in the year.

    A new player

    Flu activity is low but rising quickly in the United States, according to the latest FluView report from the U.S. Centers for Disease Control and Prevention.

    Most of the flu viruses identified this season have been an A strain called H3N2, and half of those have come from subclade K, a variant that was responsible for a rougher-than-normal flu season this summer in the Southern Hemisphere.

    That variant wasn’t a major player when scientists decided which strains should be in the annual flu shots, so the vaccines cover a related but slightly different group of viruses.

    “It’s not like we’re expecting to get complete loss of protection for the vaccine, but perhaps we might expect a little bit of a drop-off if this is the virus that sort of dominates the season, and early indications are that’s probably going to be the case,” said Dr. Richard Webby, director of the World Health Organization Collaborating Center for studies on the ecology of influenza in animals and birds at St. Jude Children’s Research Hospital.

    Early analysis by the U.K. Health Security Agency shows that subclade K has seven gene changes on a key segment of the virus. Those mutations change the shape of this region, making it harder for the body’s defenses to recognize.

    “That’s the predominant thing that our immune system targets with antibodies, and that’s also pretty much what’s in the vaccine,” said Dr. Adam Lauring, chief of the Division of Infectious Diseases at the University of Michigan Medical School.

    UKHSA scientists found that the current flu vaccines are still providing decent protection against subclade K viruses. Vaccination cut the odds of an emergency department visit or hospitalization for the flu by almost 75% in children. The effectiveness for adults, even those over 65, was lower, about 30% to 40% against needing to visit the hospital or ER.

    But the scientists offer a caveat: These results are from early in the season, before the protection from seasonal flu vaccines has had time to wane or wear off. The findings are posted in a recent preprint study, which means it was published ahead of scrutiny from outside experts.

    Still, some protection is better than no protection, and while subclade K is expected to dominate the season, it won’t be the only flu strain circulating. No one gets to pick what they’re exposed to. Lauring said his daughter has just recovered from the flu, but it was a B-type strain.

    At the same time this new variant has emerged, flu vaccinations appear to be down in the U.S. According to IQVIA, about 64% of all flu vaccinations were administered at retail pharmacies, which administered roughly 26.5 million flu shots between August and the end of October. That’s more than 2 million fewer shots than the 28.7 million given over the same time frame in 2024.

    “I’m not surprised,” said Dr. Jennifer Nuzzo, who directs the Pandemic Center at Brown University’s School of Public Health. Vaccine skepticism expressed by leaders of the US Department of Health and Human Services has “injected chaos into the whole vaccination system,” she said.

    “There’s been a lot of attention on really non-issues,” like vaccine ingredients and separating shots, that she thinks “at the best, left people confused but possibly at the worst have left people worried about getting vaccinated,” she added.

    Flu vaccinations have also fallen in Australia, where subclade K was the predominant virus this year. As a result, flu hit a record, with more than 443,000 cases. Flu season in the Southern Hemisphere typically runs from May to July, so infectious disease experts often look to those countries for a preview of what might be on the way to North America.

    “What they saw in Australia is that they had a bad season. And so it’s concerning for you and us, what’s coming,” said Dr. Earl Rubin, director of the infectious disease division at the Montreal Children’s Hospital in Canada.

    ‘This is the time we start to see the rise’

    It’s difficult to say whether subclade K actually makes a person sicker than other flu strains, but if it drives more cases, it will certainly drive hospitalizations too, Rubin said.

    “When you look at severity, the more cases you have, if the same percentage get hospitalized, obviously you’re going to have more hospitalization if you have more cases. So it sometimes will look like the severity is also worse,” he said.

    Lab testing data has begun to show an uptick in flu cases.

    “This is the time we start to see the rise,” said Dr. Allison McMullen, a clinical microbiologist at BioMerieux, which makes the BioFire test, a popular diagnostic tool for respiratory pathogens.

    The company anonymously compiles its test results into a syndromic surveillance tool, which can offer a glimpse of what bugs are making people sick at any given time. At the beginning of the month, less than 1% of tests were positive for type A flu. Now it’s 2.4% – still low numbers but going up briskly, which aligns with the CDC trend.

    “We’re going to start seeing heavy holiday travel before we know it,” McMullen added. “With the rising cases that we’re seeing the U.K. and Japan, it can definitely be a bellwether for what we’re going to see in North America.”

    Signals are also rising in wastewater, said Dr. Marlene Wolfe, an assistant professor of environmental health at Emory University. In October, 18% of samples in the WastewaterSCAN network — an academically led wastewater monitoring program based at Stanford University, in partnership with Emory — were positive for type A flu, Wolfe said. In November, that number had risen to 40%.

    “Flu is something where, when it’s not in season, we don’t detect it very frequently in wastewater,” Wolfe said. COVID, on the other hand, can be detected pretty much all the time, which makes it challenging to know if it’s going up or down, she said.

    The scientists can set a threshold for when they can declare that a specific area is in flu season, Wolfe says. So far, just four of the 147 sites they monitor in 40 states have reached that threshold. Those sites are in the Northeast — in Maine and Vermont — in Iowa and in Hawaii.

    “I am concerned, I guess, that we could have a big flu season this year based on what we’re seeing in other parts of the world, and particularly Europe and elsewhere,” Michigan’s Lauring said.

    “It’s not too late. Go and get your flu shot,” Lauring advised. “And be alert that it’s out there.”

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  • Valley fever strikes attendees of Kern County music festival

    Valley fever strikes attendees of Kern County music festival

    California health officials are urging people who attended the Kern County music festival Lightning in a Bottle to seek medical care if they are experiencing respiratory symptoms or a fever.

    Authorities have identified five patients with valley fever who attended the six-day event, which was held May 22-27 at Buena Vista Lake, near Bakersfield. Three people have been hospitalized.

    More than 20,000 people attended the festival.

    One attendee, on a Reddit r/LightningInaBottle thread, said a festival companion had been hospitalized for two weeks with “severe” valley fever.

    “If you get unexplainable symptoms such as fever, chills, and headaches/neck pain,” the user wrote, “let the doctors know it could be valley fever, even though it’s been several months.”

    Valley fever is an infectious disease caused by the coccidioides fungus, which grows in the soil and dirt in some areas of California. It is most commonly found in the San Joaquin Valley and Central Coast of California.

    Health officials say that most people exposed to this fungus don’t end up developing the disease, but it can infect the lungs and cause respiratory symptoms in some people, including cough, difficulty breathing, fever and fatigue.

    In rare cases, the fungus can spread to other parts of the body and cause severe disease.

    Valley fever is not contagious. Past outbreaks have been linked to dust and dirt exposure at outdoor events and job sites where dirt is disturbed — in areas of the state where the fungus is common.

    Valley fever is on the rise in California, with particularly high numbers of cases reported in 2023 and 2024. The fungus appears to flourish in wet years.

    A 2022 study in the medical journal the Lancet concluded that multiyear cycles of dry conditions followed by wet winters increased transmission, especially in areas that were historically wetter. Climate change is expected to increase the frequency and duration of drought throughout the Southwestern United States, potentially increasing the prevalence of valley fever spores and fungus.

    Kern County has the highest incidence rate in the state, and it accounts — on average — for about a third of the cases.

    State health officials say that people who have visited Kern County in recent months and are experiencing respiratory symptoms that have not improved or are lasting longer than a week should see a healthcare provider and ask about possible valley fever.

    They also urge people to mention attendance at the music festival or travel to Kern County.

    Attendees can visit the California Department of Public Health’s valley fever survey website for more information and to share details about any illness.

    Another Reddit user said they came down with the disease two weeks after returning from the festival to their home in Colorado.

    The music fan described a “terrible” cough, headache, body aches, fever and chills. The Reddit user is not sure they’d go again next year.

    “Don’t want to miss … but I also don’t want a fungal lung infection again. Yikes.”

    Susanne Rust

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  • 11 Possible Heart Symptoms You Shouldn’t Ignore

    11 Possible Heart Symptoms You Shouldn’t Ignore

    If something went wrong with your heart, would you know it?

    Not all heart problems come with clear warning signs. There is not always an alarming chest clutch followed by a fall to the floor like you see in movies. Some heart symptoms don’t even happen in your chest, and it’s not always easy to tell what’s going on.

    “If you’re not sure, get it checked out,” says Charles Chambers, MD, director of the Cardiac Catheterization Laboratory at Penn State Hershey Heart and Vascular Institute.

    That’s especially true if you are 60 or older, are overweight, or have diabetes, high cholesterol, or high blood pressure, says Vincent Bufalino, MD, an American Heart Association spokesman. “The more risk factors you have,” he says, “the more you should be concerned about anything that might be heart-related.”

    Especially watch out for these problems:

    1. Chest Discomfort

    It’s the most common sign of heart danger. If you have a blocked artery or are having a heart attack, you may feel pain, tightness, or pressure in your chest.

    “Everyone has a different word for that feeling,” Chambers says. “Some people say it’s like an elephant is sitting on them. Other people say it’s like a pinching or burning.”

    The feeling usually lasts longer than a few minutes. It may happen when you’re at rest or when you’re doing something physical.

    If it’s just a very brief pain — or if it’s a spot that hurts more when you touch or push on it — it’s probably not your heart, Chambers says. You should still get it checked out by a doctor. If the symptoms are more severe and don’t go away after a few minutes, you should call 911.

    Also, keep in mind you can have heart problems — even a heart attack — without chest pain. That’s particularly common among women.

    2. Nausea, Indigestion, Heartburn, or Stomach Pain

    Some people have these symptoms during a heart attack. They may even vomit, Chambers says.

    Women are more likely to report this type of symptom than men are.

    Of course, you can have an upset stomach for many reasons that have nothing to do with your heart. It could just be something you ate, after all. But you need to be aware that it can also happen during a heart attack.

    So if you feel this way and you’re at risk for heart problems, let a doctor find out what’s going on, especially if you also have any of the other symptoms on this list.

    3. Pain that Spreads to the Arm

    Another classic heart attack symptom is pain that radiates down the left side of the body.

    “It almost always starts from the chest and moves outward,” Chambers says. “But I have had some patients who have mainly arm pain that turned out to be heart attacks.”

    4. You Feel Dizzy or Lightheaded

    A lot of things can make you lose your balance or feel faint for a moment. Maybe you didn’t have enough to eat or drink, or you stood up too fast.

    But if you suddenly feel unsteady and you also have chest discomfort or shortness of breath, get medical help right away.

    “It could mean your blood pressure has dropped because your heart isn’t able to pump the way it should,” Bufalino says.

    5. Throat or Jaw Pain

    By itself, throat or jaw pain probably isn’t heart related. More likely, it’s caused by a muscular issue, a cold, or a sinus problem.

    But if you have pain or pressure in the center of your chest that spreads up into your throat or jaw, it could be a sign of a heart attack. Call 911 and seek medical attention to make sure everything is all right.

    6. You Get Exhausted Easily

    If you suddenly feel fatigued or winded after doing something you had no problem doing in the past — like climbing the stairs or carrying groceries from the car — make an appointment with your doctor right away.

     

    “These types of significant changes are more important to us than every little ache and pain you might be feeling,” Bufalino says.

     

    Extreme exhaustion or unexplained weakness, sometimes for days at a time, can be a symptom of heart disease, especially for women.

    7. Snoring

    It’s normal to snore a little while you snooze. But unusually loud snoring that sounds like a gasping or choking can be a sign of sleep apnea. That’s when you stop breathing for brief moments several times at night while you are still sleeping. This puts extra stress on your heart.

    Your doctor can check whether you need a sleep study to see if you have this condition. If you do, you may need a CPAP machine to smooth out your breathing while you sleep.

    8. Sweating

    Breaking out in a cold sweat for no obvious reason could signal a heart attack. If this happens along with any of these other symptoms, call 911 to get to a hospital right away. Don’t try to drive yourself.

    9. A Cough That Won’t Quit

    In most cases, this isn’t a sign of heart trouble. But if you have heart disease or know you’re at risk, pay special attention to the possibility.

    If you have a long-lasting cough that produces a white or pink mucus, it could be a sign of heart failure. This happens when the heart can’t keep up with the body’s demands, causing blood to leak back into the lungs.

    Ask your doctor to check on what’s causing your cough.

     

    10. Your Legs, Feet, and Ankles Are Swollen

    This could be a sign that your heart doesn’t pump blood as effectively as it should.

    When the heart can’t pump fast enough, blood backs up in the veins and causes bloating.

    Heart failure can also make it harder for the kidneys to remove extra water and sodium from the body, which can lead to bloating.

    11. Irregular Heart Beat

    It can benormal for your heart to race when you are nervous or excited or to skip or add a beat once in a while.

    But if you have started feeling palpitations, check in with your doctor. Call 911 if you have palpitations or an irregular heartbeat that persists or if you also have any chest pain or pressure, dizziness, or shortness of breath.

    “In most cases, it’s caused by something that’s easy to fix, like too much caffeine or not enough sleep,” Bufalino says. But occasionally, it could signal a condition called atrial fibrillation that needs treatment. So ask your doctor to check it out.

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