There is a widespread idea that can be dangerous: the idea that if one “feels good,” the heart is fine. The reality is
distinctive. Cardiovascular diseases are the leading cause of death in Panama and the world, and one of the reasons is
Exactly that: they progress silently. Many people with hypertension, high cholesterol, or even significant obstructions in the arteries do not show any obvious symptoms until an acute event occurs, such as a heart attack.
That is why at Hospital Clínica San Fernando we insist on a simple message: feeling well is not the same thing as being well. The only way to truly know how your heart is doing is through a medical evaluation and, when appropriate, specific cardiac studies.
Below, we explain seven signs that are often ignored or attributed to stress, fatigue, or age, but which can actually be the early warning signs that your heart needs attention.
1. Unusual fatigue when performing everyday activities
Climbing a flight of stairs, carrying the bags from the market, or walking a few blocks should not leave you without air in a disproportionate way.
When an activity that you used to do without any problems now exhausts you, it can be a sign that your heart is working harder than it should to pump blood efficiently.
2. Shortness of breath that appears or worsens with exertion
Difficulty breathing, especially when you lie down, during light exercise or when climbing a hill, is one of the most common and at the same time most underestimated cardiac signs. Many people blame it on a lack of fitness, when in reality it can reflect that the heart is not pumping with the necessary force.
3. Palpitations or feeling of “heart racing”
Feeling your heart beat faster, skipping a beat, or “fluttering” occasionally isn’t always serious, but when these episodes happen repeatedly, last for several minutes, or are accompanied by dizziness, they do deserve evaluation. They may be related to arrhythmias that, without treatment, increase the risk of more serious complications.
4. Pain, pressure, or discomfort in the chest
This is perhaps the most well-known symptom, but also one of the most misinterpreted. It does not always present as intense pain: sometimes it is a sensation of oppression, burning, or heaviness that is mistaken for acidity or muscle fatigue. Any recurring discomfort in the chest, especially if it appears with exertion and improves with rest, should be evaluated seriously.
5. Swelling in the legs, ankles, or feet
Fluid retention in the lower extremities can be a sign that the heart is not pumping blood efficiently, which causes fluid accumulation in the circulatory system. If you notice that your shoes feel tighter at the end of the day or that the skin on your ankles becomes rough when you press them, tell your doctor about it.
6. Vertigo or feeling of fainting frequently
Occasional dizziness can have many causes, but when it occurs along with palpitations, shortness of breath, or chest pain, it is important to rule out a cardiac origin. The brain needs a constant flow of oxygenated blood, and any disruption in the rhythm or pumping force of the heart can affect it.
7. Family history and risk factors that “do not cause symptoms”
This last sign is not a physical symptom, but a risk factor that is often overlooked: having direct family members with heart disease, hypertension, diabetes, or high cholesterol, being a smoker, being overweight, or leading a sedentary lifestyle. These factors do not always cause any discomfort, but they significantly increase the likelihood of developing a cardiovascular problem, and are reason enough to undergo a checkup even if there are no symptoms.
What cardiac studies exist and what are they for?
One of the main obstacles to undergoing a heart check is not knowing which study is appropriate for each situation. At Hospital Clínica San Fernando we have the technology and specialized staff to perform the most important cardiac evaluations:
Electrocardiogram (ECG): It is the initial and most basic study. It records the electrical activity of the heart and allows the detection of arrhythmias, signs of a previous heart attack, or alterations in electrical conduction. It is quick, non-invasive, and is usually the first step in any cardiac evaluation.
Echocardiogram: It uses ultrasound to observe the structure and function of the heart in real time: the size of the chambers, the condition of the valves, and the pumping force. It is key to detecting structural problems that an electrocardiogram cannot show.
Test of effort: It assesses how the heart responds when it is required to work harder, usually by walking on a treadmill at increasing speed and incline. It helps detect obstructions in the coronary arteries that may not be evident at rest.
Holter monitoring: It is a portable device that records the electrical activity of the heart for 24 to 48 continuous hours. It is very useful for capturing arrhythmias that appear sporadically and that a few-second electrocardiogram would not be able to record.
Cardiac tomography: It allows for detailed images of the coronary arteries and the detection of calcification or obstructions with high precision, without the need for invasive procedures.
Each of these studies addresses a different need, and it is the specialist physician who determines, based on the symptoms, the patient's history and risk factors, which one or more of these treatments are necessary.
Prevention remains the best tool
Heart disease does not appear overnight. It develops over years, often without warning, until the body can no longer compensate for accumulated damage. The good news is that much of this risk can be identified in time with periodic assessments, and many risk factors—such as hypertension, high cholesterol, or being sedentary—are controllable when detected early.
If you identified with any of these signs, or if it has been a while since your last cardiology checkup, don't wait for a more serious symptom to appear. At Hospital Clínica San Fernando, we have specialists in cardiology and the necessary technology to assess the health of your heart in a comprehensive way.
Your heart works for you every day, without rest. Giving it that attention with a timely checkup can make the difference between early detection and an avoidable emergency.
Medical checkups that should be done according to your age
“I feel fine; I don’t need to see a doctor.” This is one of the most common phrases we hear, and also one of the most dangerous. Preventive medicine does not exist for people who are already ill; it is precisely to detect in time what still does not show symptoms. And this changes with each stage of life: what needs to be monitored at 25 is not the same as at 45 or at 65.
At Hospital Clínica San Fernando we believe that one of the best gifts you can give yourself — and to your family — is to know exactly which checkups are appropriate for your age. Here we provide a practical guide, organized by decade of life, to help you know what to prioritize and when.
From 20 to 29 years old: laying the foundations
At this stage, most people feel invincible, and it’s understandable: the body still compensates well for excess. But it’s also the ideal time to establish a relationship with a primary care doctor and create a complete health history.
Recommended check-ups: – Annual consultation with a primary care physician – Blood pressure and weight/BMI – Lipid profile (cholesterol) at least once, especially if there is a family history – Fasting blood glucose – Routine visual and dental examinations – In women: Pap smear starting at the beginning of sexual life or at 21 years of age, as indicated by a doctor.
Although chronic diseases are uncommon at this age, the habits formed now—nutrition, physical activity, sleep, alcohol or tobacco consumption—will largely determine the cardiovascular and metabolic risk in the coming decades.
From 30 to 39 years: the decade of early signs
Here, the first signs of metabolic wear begin to appear in many people, especially if there is a family history of diabetes, hypertension, or heart disease. The pace of life—work, children, stress—also tends to push self-care to the back burner, just when it is most necessary to strengthen it.
Recommended checkups: – Complete laboratory tests (complete blood count, lipid profile, blood glucose, renal and liver function) every 1-2 years – Blood pressure at each medical visit – Mental health assessment and stress levels – In women: baseline mammography based on family history, and annual gynecological check-up – In men: urological assessment if there are symptoms or a family history
From 40 to 49 years old: time to intensify surveillance
The 40 mark marks a real turning point. Cardiovascular risk begins to rise more noticeably, and the likelihood of detecting certain cancers at stages that are treatable also increases if they are detected in time.
Recommended checkups: – Cardiological check-up: electrocardiogram and evaluation by a specialist, especially if there is a family history or risk factors – Lipid profile and annual blood glucose level – Annual mammography starting at age 40 for women – Reference colonoscopy, especially if there is a family history of colorectal cancer (some guidelines recommend it starting at age 45) – Prostate-specific antigen (PSA) in men, as indicated by the urologist – Eye examination to detect age-related changes.
From 50 to 59 years: the decade of active prevention
At this stage, most important preventive studies should already be part of the annual routine. It is also when many chronic diseases—if not detected earlier—begin to manifest themselves more clearly.
Recommended checkups: – Colonoscopy (if not already done) and then every 5-10 years depending on the result – Complete cardiac check-up: may include echocardiogram or stress test depending on individual risk – Bone densitometry, especially in women after menopause – Mammography and annual gynecological evaluation – Annual prostate evaluation in men – Eye and hearing control: from age 60 onwards: take care of the quality of life
Starting in this decade, the goal of checkups expands: it’s not just about detecting diseases; it’s about preserving functionality, mobility, and independence. Medical visits often become more frequent and coordinated among different specialists.
Recommended checkups: – Cardiological evaluation and blood pressure control at each visit – Complete laboratory tests every 6-12 months – Evaluation of renal, thyroid and bone function – Imaging studies based on previous history: CT scans, ultrasound or specific resonance imaging – Evaluation of memory and cognitive function – Review of vision, hearing and balance to prevent falls – Update of vaccination schedule (influenza, pneumococcus, booster vaccinations as indicated)
The constant throughout all ages: primary care
Beyond the decade you’re in, there’s a common thread: the importance of having a primary care doctor who knows your history and can guide you on which labs and imaging tests you need, and how often. Not all checkups apply equally to everyone; family history, lifestyle habits, and pre-existing conditions adjust these general recommendations to each individual case.
At Hospital Clínica San Fernando we have primary care doctors, specialists and a laboratory with imaging technology that allows us to cover most of these tests in one place, according to your stage of life.
Preventive medicine is not meant to alarm you: it aims to provide you with the information you need to make timely decisions. Knowing which check-ups correspond to your age is the first step towards ensuring that your health care no longer becomes a reaction to a problem but becomes a constant habit.
