Emerging research and expert consensus warn that many early signs of heart problems go undetected until serious health consequences arise, urging Thai readers to take seemingly mild symptoms more seriously. A new review featuring leading cardiologists, published on May 31, 2025, details the top eight signs that should prompt a visit to a heart specialist and contextualizes the relevance for Thai society, where cardiovascular disease remains one of the primary causes of death and disability (EatingWell, Statista, WHO, RCPT Guidelines).
Cardiovascular diseases continue to be the leading cause of mortality and long-term disability in Thailand, rivaling cancer in national health statistics (Trade.gov report). With over 958,000 patients recorded per 100,000 population suffering from some form of heart disease in 2022, the burden is acute and rising (Statista). Experts and recent Ministry of Public Health guidelines (RCPT 2024) stress the urgent need for early detection and preventive care, especially as many Thais still consider heart disease as affecting mostly the elderly or those with obvious risk factors. The truth is subtler, and everyone—regardless of age—should know these eight warning signs.
First and most famously, chest pain or discomfort often signals cardiac trouble. This discomfort may feel like pressure, tightness, or even burning and can radiate to the arm, neck, jaw, or back. Not all chest pain is heart-related, but ignoring it can be life-threatening. As noted by the Interventional Cardiologist at MemorialCare Saddleback Medical Center, “Some symptoms, such as chest pain, could represent a serious heart issue that requires urgent or even emergency care. Evaluating potential heart problems can prevent them from getting worse and maybe even save your life” (EatingWell).
The second red flag is unexplained shortness of breath, especially when performing everyday activities such as walking upstairs, carrying groceries, or even lying down. While mild breathlessness can sometimes be attributed to being out of shape, a sudden or persistent change is a warning sign. In the words of an Internal Medicine expert interviewed in the report, “Shortness of breath may be a sign that not enough blood is flowing out of the heart, which can be a sign of congestive heart failure or valve disease. A cardiologist can check how well your heart is working and determine if there’s an underlying cardiovascular problem” (EatingWell).
The third sign—an irregular heartbeat or palpitations, which may feel like a racing, fluttering, or pounding heart—is sometimes dismissed as anxiety or stress. However, if these symptoms are prolonged, frequent, or accompanied by dizziness, they could indicate arrhythmias, which, if unaddressed, dramatically increase the risk of stroke or cardiac arrest. Research published in 2025 in leading cardiology journals confirms that patients with atrial fibrillation are more likely to carry gene variants associated with inherited heart conditions, reinforcing the need for early medical attention (PubMed).
Next, swelling in both legs or ankles, known as edema, merits special attention. While Thai readers are familiar with swollen legs resulting from long flights, high salt Thai diets, or tropical heat, swelling that persists for more than a few days, or occurs with shortness of breath and palpitations, is particularly worrisome. Cardiologists warn that such swelling may be caused by the heart’s inability to pump efficiently, leading to fluid accumulation in lower extremities—an early sign of heart failure (EatingWell, Trade.gov NCD report).
High blood pressure—known as โรคความดันโลหิตสูง in Thai—is a major cardiovascular risk factor that often produces no symptoms until damage is done. Many Thais mistakenly believe that feeling healthy equals being healthy. In reality, silent high blood pressure can steadily damage blood vessels and the heart itself, causing disease even in people who feel fine. Healthcare authorities and provincial hospitals alike urge all adults to have annual check-ups, especially if they have family histories of hypertension or other cardiovascular risks (RCPT 2024 guidelines, WHO Thailand data).
The sixth sign is unexplained lightheadedness or chronic fatigue. While it is easy to attribute fatigue to long work hours, family responsibilities, or Bangkok’s notorious traffic-jams, persistent symptoms may reflect underlying heart problems. According to a Cardiology Specialist at Your Doctors Online, “Brain fog or trouble concentrating is another one. People often assume it’s stress or poor sleep, but if it comes with low blood pressure, dizziness, or fatigue, I might look into whether the heart’s pumping efficiently enough to keep the brain properly supplied with oxygen” (EatingWell).
Seventh, the presence of other chronic illnesses—known medically as comorbidities—greatly raises the risk of developing heart disease. In Thailand, hypertension, diabetes, and high cholesterol are now widespread due to rapid urbanization, dietary changes, and sedentary lifestyles (Nature, BMJ). Patients with kidney disease, sleep apnea, chronic lung disease, and obesity should monitor their heart health extra closely and have regular screenings, as recommended by the Heart Failure Council of Thailand (HFCT 2019).
Finally, a family history of heart disease is one of the strongest predictors of future risk. Thais often underreport or overlook family medical history during routine check-ups, yet inherited traits play a large role in heart health (EatingWell). According to experts from Miami Cardiac & Vascular Institute, if close family members have suffered from heart disease—especially at a young age—it is wise for relatives to be proactive, regardless of whether they feel healthy or not.
It is important to remember that many signs of cardiovascular disease are non-specific: they might not seem dramatic or could be mistaken for other ordinary causes. Leading medical practitioners emphasize the importance of context and expert evaluation: “In cardiology, we’re trained to look for patterns—not just dramatic symptoms, but the quiet ones that often get overlooked. The tricky part is that a lot of these signs could point to something heart-related, or they could be from something else entirely. That’s why context matters so much,” stresses a specialist at Your Doctors Online (EatingWell).
For Thailand, these warning signs have heightened urgency due to local lifestyle patterns and risk trends. Cigarette smoking, increasingly sedentary office work, reliance on high-salt and high-fat diets (such as somtum with extra nam pla, deep-fried snacks, or late-night noodle stalls), and insufficient regular exercise are contributing to a rising incidence of heart disease. A 2023 study notes that high systolic blood pressure, high body mass index, and persistent smoking remain the leading lifestyle-related risk factors for heart problems in Thailand (Nature, WHO). Furthermore, despite existing community health education programs, there remains an urgent need to destigmatize heart disease in rural and urban Thai settings and encourage open discussion of potential symptoms and family history among all age groups.
Historically, Thai society has held cultural beliefs about energetic balance (lom prachoon), herbal self-treatment, or reliance on traditional healing before seeking hospital care for heart symptoms. While traditional approaches remain highly valued, contemporary evidence emphasizes the importance of integrating modern diagnostic techniques, such as ECGs, stress tests, and echocardiography, alongside primary care assessments. Thailand’s Ministry of Public Health and the Royal College of Physicians of Thailand have ramped up public awareness campaigns, but gaps in early detection persist, especially in rural communities (RCPT 2024 Guidelines).
New research from PubMed in 2025 reflects an evolution in heart care—earlier diagnosis and innovative therapies (such as sodium-glucose cotransporter-2 inhibitors for heart failure with preserved ejection fraction) are saving more lives (PubMed). Genetic insights are helping to identify those with familial risks, while improved understanding of comorbidities, such as diabetes and kidney disease, is shaping targeted screening protocols. Increased digital health solutions and telemedicine consultations are now enabling more Thais, regardless of location, to access specialist consultations—though significant rural-urban barriers remain.
Looking forward, the stakes for Thailand are clear: as the population ages and lifestyles continue to Westernize, the burden of cardiovascular disease will increase unless prevention and early intervention are prioritized. Proactive steps—such as regular annual health check-ups, maintaining healthy blood pressure through diet and exercise, avoiding smoking, and knowing family history—are essential. Thai workplaces, schools, and community temples can play active roles in education and screening, helping to ensure that early warning signs of heart disease do not go unnoticed.
In summary, Thai readers are urged to stay vigilant for the eight signs highlighted by medical experts: unexplained chest pain, shortness of breath, irregular heartbeat or palpitations, swelling in the legs or ankles, high blood pressure, unexplained fatigue or dizziness, other chronic health conditions, and a family history of heart disease. These symptoms—especially when present in combination—should prompt an appointment with a healthcare professional, and ideally, a cardiologist with expertise in cardiovascular risk assessment. Prevention remains the best medicine, and small, informed steps today can avert tragedy tomorrow.
For practical action:
- Schedule annual health check-ups, even if you feel healthy
- Monitor your blood pressure at home and at pharmacies
- Discuss any persistent or new symptoms promptly with a healthcare provider
- Adopt a balanced Thai diet, emphasizing fresh vegetables, whole grains, and reduced salt, oil, and sugar
- Engage in regular moderate exercise (such as brisk walking, traditional dance, or playing sepak takraw)
- Encourage open dialogue about family medical history with relatives
- Participate in community heart health awareness events, often led by local healthcare volunteers (อสม.)
Staying aware of your own body and family history is essential. For Thais of all ages, remembering and acting upon these warning signs can save lives and help the entire community maintain heart health for generations to come.
For readers seeking further information, consult the latest guidance from the Royal College of Physicians of Thailand (RCPT 2024 guidelines) or discuss with your local hospital’s cardiology department.