Charlotte-based cardiologist Kaustubh Dabhadkar, an authority on preventive cardiology, has highlighted unusual symptoms that might signal serious heart conditions. Dr. Dabhadkar shared insights on how these symptoms are not only challenging to diagnose but also easily overlooked.
Atypical Symptoms: A Diagnostic Challenge
Traditional heart attack symptoms like chest pressure that radiates to the arm or jaw are well-known and straightforward to identify. However, less typical symptoms can be elusive, making them difficult to diagnose. A study from the Journal of the American College of Cardiology in 2025 discovered that over 99 percent of individuals developing coronary artery disease, heart failure, or stroke exhibited at least one risk factor prior to diagnosis.
These factors include high blood pressure, high cholesterol, elevated blood sugar, or a smoking history.
An Anecdote from Practice
The heart has no private line for pain.
Dr. Dabhadkar recounted an incident during his cardiology fellowship that underscored this adage. Awoken at 2 AM to assess a patient with an earache, he initially dismissed the case as non-urgent. Yet, an EKG revealed a heart attack in progress. The patient’s major artery was compromised, and the pain was localized uniquely in the earlobe.
Following the opening of the artery, the ear pain resolved, illustrating how heart-related issues can manifest unexpectedly.
Understanding Referred Pain
The nerves of the heart intersect with those in the chest, shoulders, arms, neck, jaw, and upper abdomen. This can lead the brain to misinterpret signals, a phenomenon known as referred pain. Unusual symptoms such as persistent cold sweats can accompany heart issues, yet many patients rationalize these as benign.
Atypical Presentations and Risk Awareness
About one-third of heart attack patients experience no chest pain. While younger individuals typically manifest chest pain during heart attacks, it becomes rare for those over 85. Symptoms easily misconstrued include jaw, teeth, or throat discomfort, upper back pain, or unexplained fatigue and breathlessness.
Dr. Dabhadkar is particularly cautious about new symptoms that worsen with effort but improve with rest, especially if combined with cold sweats, nausea, or a foreboding sense. Such occurrences prompt him to recommend an EKG.
Though ear lobe pain should not become a standard checklist item, Dr. Dabhadkar emphasizes the importance of erring on the side of caution: he prefers evaluating numerous false alarms over missing a genuine heart attack.
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