Newswise — Heart disease is the leading cause of death in the United States—an equal opportunity killer that claims approximately 1 million lives annually. The heart and arteries comprise one of our bodies’ largest organ systems, and, when they begin to fail, symptoms may manifest in seemingly unrelated parts of the body. Texas A&M Health Science Center cardiologist, John P. Erwin, M.D., delves into a few surprising clues that can ultimately point to an unhealthy heart.

1. Sexual problemsFor males, erectile dysfunction is a common manifestation of arterial disease. The buildup of plaque in the arteries of the body is believed to be the reason erectile dysfunction precedes heart problems in men.In females, a drop in libido often signals a post-menopausal state and women who are post-menopausal rapidly increase their risk factors for developing heart disease. While menopause doesn’t cause cardiovascular diseases, certain heart-health risks—like changes in blood pressure and cholesterol levels—begin around the time of menopause. Many women also develop a more sedentary lifestyle in this phase of their lives.

2. Snoring/Sleep ApneaSnoring is a common sign of sleep apnea, as is morning sleepiness after a full night’s sleep. Sleep apnea (periods of time during sleep where you stop breathing) is associated with many physiological changes that increase the risk of both heart attack and stroke. It may also be a sign of atrial fibrillation (an irregular, often rapid heart rate that causes poor blood flow). Detection and treatment of sleep apnea has been proven to lower heart risks.

3. Sore, swollen or bleeding gumsUnhealthy gums can be a symptom of periodontitis (a serious gum infection that damages gums and can destroy the jawbone)—and this condition can lead to an increased inflammatory state throughout the entire body. We know that the over-activity of inflammatory pathways in our body can be a strong risk factor for the development of atherosclerotic (arterial) heart disease and heart attack. It is recommended people follow up regularly with their dentist for oral hygiene in addition to regular brushing and flossing.

4. Puffy legs and feetThere are many causes of swelling in the legs and feet, but it can be a marker for congestive heart failure—especially if the person is having unusual shortness of breath with activity or when trying to sleep. Some swelling occurs naturally as the day goes on and resolves overnight, but, persistent or worsening of this pattern should prompt a visit to your physician for evaluation of heart failure.

5. Aching or constriction in the shoulders or neckNot all people have the classical feeling of “an elephant sitting on my chest” or “a squeezing sensation in my arms” when they are experiencing a heart attack. Many people may feel a very uncomfortable sensation, achiness, pain, or pressure in their neck, jaw, and/or shoulders as the only sign of heart pain or a heart attack.

6. Heartburn or indigestionA burning or aching sensation in the upper abdomen, or persistent gastrointestinal distress like intractable hiccups, can also be a sign of heart pain or a heart attack. One should be especially concerned if this is occurring with nausea, sweating, shortness of breath, or lightheadedness. It is not uncommon to see people come to the emergency room after chewing on antacids for hours before they realize the pain is something more.