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Right now, as you read this, your heart is beating away and moving blood throughout your body. When your heart is working normally, you won’t notice it at all. But there are ways our hearts let us know if something isn’t quite right. Identifying these symptoms, and responding to them, can help prevent heart disease, which is the leading cause of death for men and women and affects nearly half of all American adults.

“No matter what your age, no matter whether you’re a man or a woman, we are all at risk for heart disease,” says cardiologist Lawrence Phillips, MD, assistant professor in the and medical director of outpatient clinical cardiology at NYU Langone. “If you are experiencing symptoms, the longer you wait to get them evaluated, the greater your risk of something going wrong.”

Here are five signs of heart trouble you need to get checked out: 

1. Chest Pain

“Chest pain is never normal,” says Dr. Phillips. And by that, he means any kind of chest discomfort, including the “elephant sitting on my chest” feeling, but also sharp pains, a burning sensation, or a tugging feeling in the chest, all of which could be your heart’s way of saying it is not getting enough oxygen. “If it’s a new symptom, have it checked out,” says Dr. Phillips.

Chest pain, also known as angina, can signal coronary artery disease that results from atherosclerosis, or plaque buildup, in the arteries that supply the heart. This can be treated with medication, angioplasty with stenting, or surgery.

2. Shortness of Breath

Shortness of breath is best explained as a change in your normal breathing pattern. Is it hard to take a deep breath? Do you get winded more easily during exercise or walking up a flight of stairs? When you lie down, do you have trouble breathing, or do you wake up in the middle of night trying to catch your breath? These are all signs that your heart might not be working efficiently, says Dr. Phillips.

Shortness of breath can be related to many different heart conditions, such as mitral valve disease, aortic valve disease, heart attack, and heart failure.

It is important to note, Dr. Phillips says, that heart disease symptoms for women can vary from those experienced by men. “Women are more likely to have shortness of breath and nausea,” says Dr. Phillips. 

3. Heart Palpitations

If you feel your heart racing for longer than seems normal, that is worthy of a call to your doctor. “When you exercise, you’ll feel your heart beating more strongly,” says Dr. Phillips. “But palpitations that continue for minutes or even hours are not normal.” Palpitations can be a sign of atrial fibrillation and other arrhythmias that alter heart rhythm.

4. Loss of Consciousness

When a person faints or passes out, it’s often sudden—they fall to the floor, for instance, and have no memory of what happened when they regain consciousness. This could be a sign of a dangerous heart rhythm disorder that can lead to sudden cardiac arrest and should never be ignored.

5. Dizziness

Dizziness is defined as feeling like the room is spinning or you are going to pass out. This can be due to a slow or fast heart rhythm, and can indicate that your heart’s electrical system is not firing properly. “This could be a sign of an arrhythmia, or of a heart valve condition,” Dr. Phillips says. “It’s important to get an EKG to look for an irregular heart rhythm and make sure there is no major problem.”

When to See Your Doctor 

If you are experiencing symptoms, it’s always a good idea to see a doctor.  

“In some cases patients come in and we discover nothing is wrong,” Dr. Phillips says. “They then apologize for ‘wasting my time.’ But I tell them, ‘You did not waste my time. This was the best possible outcome.’ Waiting puts you at higher risk for something worse happening, so never hesitate to call your doctor.” 

In an Emergency 

Heart attacks and strokes require emergency care and can’t wait for a visit to the doctor. If the symptoms are severe, call 911 or go to your nearest emergency department.