By Dr. Nithin V Adithiyaa
Every heartbeat matters. But sometimes, the heart speaks quietly. Don’t ignore it. Don’t dismiss it. Every year on 29 September, World Heart Day reminds us that cardiovascular health is not only a concern for people who already have heart disease. It is something every one of us should think about, protect and actively maintain.
The theme for World Heart Day 2026, “Don’t Miss a Beat,” highlights something cardiologists encounter every day: heart disease does not always announce itself dramatically.
A heart attack does not always begin with someone collapsing with severe chest pain. A serious rhythm disorder may first present as unexplained tiredness or dizziness. Heart failure may begin with gradually increasing breathlessness that a person attributes to age or lack of fitness. A dangerous cardiac condition may sometimes produce symptoms that are subtle, intermittent or easily ignored.
That is why awareness matters. Know your heart. Recognise the warning signs. Act early.
Know the warning signs
If something feels unusual, don’t automatically assume it is harmless. Chest discomfort may feel like pressure, tightness, heaviness, and squeezing, burning or even indigestion. It may spread to the arm, shoulder, back, neck, jaw or upper abdomen. It does not always have to be severe or continuous.
Unexplained breathlessness, particularly during activities that previously caused no difficulty, should not simply be attributed to age or lack of fitness. It can be associated with coronary artery disease, heart failure, valve disease, pulmonary hypertension or other cardiovascular conditions.
Sudden sweating, especially when associated with chest discomfort, nausea, weakness or breathlessness, can be a warning sign of an acute cardiac event.
Nausea or vomiting can sometimes accompany a heart attack and may be mistaken for a gastrointestinal problem. If it occurs along with chest discomfort, sweating, breathlessness, unusual weakness or discomfort in the jaw or arm, do not simply assume it is acidity.
Unusual fatigue can have many causes, but new or significant fatigue associated with breathlessness, chest discomfort, dizziness or reduced exercise capacity deserves medical assessment.
Palpitations, described as racing, pounding, fluttering, skipped or irregular beats, can be benign in some people but may indicate an arrhythmia in others. Palpitations accompanied by fainting, chest pain, breathlessness or significant dizziness should not be ignored.
Similarly, unexplained fainting, particularly during exertion, or recurrent unexplained dizziness warrants evaluation.
Heart disease does not look the same in everyone
One important misconception is that heart disease always presents in the same way.
Women, for example, can experience heart attacks with symptoms such as breathlessness, unusual fatigue, nausea, back or jaw discomfort, dizziness, weakness or chest discomfort rather than the classic dramatic chest pain many people associate with a heart attack.
People with diabetes also deserve particular attention. Diabetes can affect the nerves that transmit pain, and some people may develop significant coronary artery disease without experiencing the classic severe chest pain.
Feeling well does not necessarily mean that the arteries are healthy.
Know your numbers
Some of the most important cardiovascular risk factors can remain silent for years.
High blood pressure is one of the most important cardiovascular risk factors, yet most people with hypertension may have no symptoms at all. Untreated hypertension increases the risk of heart attack, stroke, heart failure, kidney disease and peripheral arterial disease.
So don’t wait for a headache or another symptom to check your blood pressure.
Measure it. Know it. Control it.
Cholesterol is another silent risk factor. A person can have significantly elevated LDL cholesterol and feel completely normal. Over time, cholesterol can contribute to atherosclerotic plaque within the arteries, which can contribute to heart attack, stroke and peripheral arterial disease.
Similarly, persistently elevated blood glucose can damage blood vessels and accelerate atherosclerosis. If you have diabetes or are at risk of diabetes, regular assessment of blood glucose and appropriate treatment are important components of cardiovascular prevention.
Your doctor can determine how these numbers relate to your individual cardiovascular risk.
Prevention should begin before disease appears
We should not wait until someone develops chest pain, a heart attack, heart failure or stroke before addressing cardiovascular risk.
A heart-healthy life should begin when we are young and continue throughout life.
Physical activity is an important part of this. The World Heart Federation’s “Keep the Beat” initiative encourages people to achieve 20 minutes of movement every day during September.
Walking, cycling, dancing, running, playing sport, climbing stairs or even household physical activity counts.
The important thing is to move
Start where you are. If you currently do very little physical activity, don’t wait for the perfect exercise programme. Start with a walk and gradually increase. Consistency matters far more than perfection. Heart health also begins at the dining table. A heart-friendly diet should emphasise vegetables, fruits, whole grains, legumes, nuts and seeds, appropriate sources of protein and healthy unsaturated fats, while reducing excessive intake of salt, added sugars, highly processed foods, saturated fats, trans fats and excess calories.
Reducing salt is not simply about putting less salt on your plate. Salt is also present in foods such as pickles, papads, packaged snacks, instant foods, processed meats, sauces and restaurant foods.
The goal is not to make food frightening. It is to make healthier food the normal food.
Ask yourself: “Can I eat this way for the next 20 years?”
Smoking is another major cardiovascular risk factor. Tobacco damages blood vessels, promotes atherosclerosis, increases thrombosis and significantly increases cardiovascular risk. Quitting is beneficial at any age. It is never too late to stop smoking.
Sleep matters too. Poor sleep can affect blood pressure, metabolism, weight, stress and overall cardiovascular health. If you snore heavily, have witnessed pauses in breathing during sleep, wake unrefreshed or experience excessive daytime sleepiness, discuss it with your doctor.
Stress also affects cardiovascular health, but not every chest pain is “stress.” If symptoms are new, recurrent, exertional or concerning, they deserve proper medical assessment. The label of stress should not delay the diagnosis of heart disease.
Your family history matters
You cannot change your genes, but you can change what you do with that information.
If close family members have experienced a heart attack or stroke at a young age, sudden cardiac death, cardiomyopathy, severe hypercholesterolemia or significant rhythm disorders, tell your doctor.
Family history can influence how early and how aggressively cardiovascular risk needs to be assessed.
What should a heart-health check include?
The exact evaluation should be individualised. Depending on age and risk factors, your doctor may consider blood pressure, weight and waist assessment, blood glucose or HbA1c, lipid profile, smoking and tobacco use, family history, physical activity, diet, alcohol intake, sleep, cardiovascular symptoms, kidney function and overall cardiovascular risk.
Additional tests such as ECG, echocardiography, stress testing, coronary imaging or other investigations should not automatically be performed on everyone.
The right test is the test that answers the right clinical question.
More testing does not always mean better prevention. Risk assessment should be personalised.
If you think you are having a heart attack
This is where “Don’t Miss a Beat” becomes an emergency message.
If you develop symptoms suggestive of a heart attack, particularly persistent or significant chest pressure or discomfort, breathlessness, sweating, nausea, or discomfort spreading to the arm, back, neck or jaw:
- Do not wait and see if it goes away.
- Do not assume it is acidity.
- Do not drive yourself if you may be having a heart attack.
- Seek emergency medical care immediately.
Time matters. When a coronary artery is suddenly blocked, the heart muscle downstream is deprived of oxygen. The sooner appropriate treatment restores blood flow, the more heart muscle can potentially be saved.
In cardiology, every minute matters.
We would rather prevent the heart attack than treat it
As cardiologists, we spend much of our professional lives treating people after cardiovascular disease has already appeared.
We open blocked arteries. We treat heart attacks. We control heart failure. We treat rhythm disorders. We perform interventions that restore blood flow. We implant devices when necessary.
But if you ask most cardiologists what they would prefer, the answer is simple:
- We would rather prevent the heart attack than treat it.
- We would rather identify hypertension before it causes a stroke.
- We would rather identify high cholesterol before it produces a coronary blockage.
- We would rather help someone stop smoking before tobacco damages their arteries.
- We would rather encourage exercise before diabetes and obesity become established.
- We would rather detect heart disease early than treat advanced heart failure.
Modern cardiology has extraordinary technology, powerful medications and sophisticated interventions. But the most powerful cardiovascular intervention is still often the simplest:
Prevent the disease before it happens.
Don’t Miss a Beat
This World Heart Day, don’t wait for your heart to shout.
Listen when it whispers.
Don’t ignore unexplained symptoms. Don’t postpone a health check because you feel well. Don’t assume that young age means zero risk. Don’t underestimate high blood pressure. Don’t ignore cholesterol. Don’t dismiss diabetes. Don’t normalise smoking. Don’t accept inactivity as inevitable.
Start today
- Move for 20 minutes. Eat a little better. Check your blood pressure. Know your numbers. Stop smoking. Sleep better. Talk to your doctor when something doesn’t feel right.
- Because cardiovascular disease may be the world’s leading cause of death but many cardiovascular events can be prevented, detected early or treated effectively.
- And sometimes, the difference between a missed warning and a life saved is simply recognising that something isn’t right and acting in time.
This World Heart Day, remember:
DON’T MISS A BEAT.
Listen to your heart. Protect your heart. Act for your heart.
Because every heartbeat matters.
Dr Nithin V Adithiyaa is a Consultant, Cardiology, Dr. Mehta’s Hospitals, Chennai.