Skin Changes that Signal Heart Problems
By Laura Monaghan, PA-C
While the stores are full of heart-shaped candies and flowery greeting cards, February is also a time to talk about heart health—and not just the Mediterranean diet and exercise routines. Did you know that the first signs of an underlying heart condition might be in your skin?
Your skin can serve as a window into your overall health and give signs as to what may be going on inside. For example, it becomes dry when we are dehydrated, pale when we lack iron, and yellow from liver disease. Did you know that it can also show signs about potential heart health problems? This American Heart Month, we want you to be aware of what your skin is telling you about your cardiovascular health.
Changes in Skin that Signal Heart Issues
Swelling of Lower Extremities
When monitoring cardiovascular health on the surface, one sign to look for is swelling of the lower extremities, such as your feet, ankles, and lower legs. Over time, chronic swelling can lead to thickened skin, brawny discoloration, and even ulcers, which can be a sign of heart failure. This is when the heart does not pump enough blood to the body. It could also be a sign of chronic venous insufficiency, which is when the veins are unable to sufficiently carry blood against gravity in the legs. Anecdotally, this is one of the most common signs of cardiovascular disease we see in dermatology.
Yellow Bumps Around Eyes
Another potential sign of cardiovascular disease is the development of yellow waxy bumps in the skin, especially on the upper eyelids, called xanthelasma. Xanthelasma bumps are made up of cholesterol deposits. They can indicate elevated blood cholesterol levels, which lead to plaque buildup in blood vessels, blocked arteries, and increased risk for heart attack. Almost half of all patients with xanthelasma have abnormal lipid levels and many also have diabetes or thyroid abnormalities.
Fingers & Nails
Swollen fingers with clubbing, or downturned nails, can be a sign of a lack of oxygen due to cardiac infection, heart, or lung disease. Skin that is turning blue or purple in color, especially with swelling or a mottled pattern, can indicate an underlying blood clot.
Bumps and Lesions on Hands and Feet
Painful bumps and painless red hemorrhagic lesions on the hands and feet, called Osler nodes and Janeway lesions, can be a signs of endocarditis. Endocarditis is inflammation of the inner lining of the heart’s chambers and valves most commonly due to bacterial or fungal infection. Red or purple lines under the nails, called splinter hemorrhages, can also be a sign of endocarditis when paired with a fever and irregular heartbeat.
Psoriasis
Finally, psoriasis, which can present as silvery-white plaques with underlying redness, nail pitting, or psoriatic arthritis is also associated with heart disease. The inflammation from psoriasis can affect the heart; individuals with psoriasis are more likely to have metabolic syndrome, a combination of elevated blood glucose levels, high blood pressure, increased abdominal fat, and high cholesterol.
Signs of Cardiovascular Problems in Children
Another thing to keep in mind is that children can also be at risk of cardiovascular health problems and have their own signs to be aware of. The combination of a sore throat, fever, and a red rash called erythema marginatum can indicate Rheumatic fever. This is a leading cause of heart disease in children resulting from untreated strep throat. Additionally, a very high fever with swollen, cracked, bleeding lips/mouth can indicate Kawasaki disease, which causes blood vessel inflammation that can affect the heart.
Be aware of what your body is telling you, and if you or your sweetheart notice any of these signs, consult with your primary care provider or dermatologist. While keeping up with all the potential problems and concerns can sometimes feel overwhelming, your dermatologist can help you manage your health with annual skin checks. The best Valentine’s gift is good health!
Sources:
Heart disease: 12 warning signs that appear on your skin. American Academy of Dermatology. (n.d.). https://www.aad.org/public/diseases/a-z/heart-disease-warning-signs
National Psoriasis Foundation. (n.d.). What we know about psoriasis and heart disease. What We Are Learning About Psoriasis and Heart Disease. https://www.psoriasis.org/advance/what-we-know-about-psoriasis-and-heart-disease-part2/