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Posted on: October 13, 2019 at 8:35 pm

Heart disease affects millions of people around the world and is the number one cause of death globally, according to the World Health Organization [1].

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The typical symptoms of heart disease could include chest pain, shortness of breath, or a rapid heartbeat, which are all symptoms you’ve likely heard of before [2].

However, did you know that some patients who have heart disease or another issue with their heart will have signs present on their skin? The following dermatological signs could be pointing to a problem with your heart!

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A Blue or Purple Pattern (Livedo Reticularis)

Livedo reticularis often presents as a blue or purple pattern on the skin that goes away when you apply pressure. This discoloration of the skin is actually a common sign of cholesterol embolization syndrome (CES).

CES is when cholesterol is released from plaque in the arteries and travels in the bloodstream, eventually getting stuck in the blood vessels and causing a blockage. Typically, an invasive vascular procedure will dislodge the cholesterol, but it can happen spontaneously as well.

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Even if you’ve had a heart procedure months ago, CES can still happen. Some cases will happen immediately following a procedure. The blockage can eventually lead to damaged organs, so if you have concerns about CES, seek medical attention as soon as possible [3]!

It’s important to note that livedo reticularis isn’t the same pattern that appears on the skin of some people when they feel cold, as this pattern will usually clear up once you’re warm, but for people with cholesterol embolization syndrome, it will remain.

Oval Red, Purple, or Brown Lesions (Sarcoidosis)

Sarcoidosis is a rare condition in which granulomas—areas of inflammation—occur in tissue. Patients who have sarcoidosis may have these granulomas or lesions appear on their arms and legs, but they can also occur on the face, scalp, and rear, and are usually symmetrical.

Patients who have what’s called cardiac sarcoidosis, in which these granulomas form in the heart tissue, could have a blockage in their heart. Although rare, it typically affects younger people between 25-45 years old [4].

Cardiac sarcoidosis has also been associated with an arrhythmia (an irregular heartbeat) and congestive heart failure [5].

What should you look for? Although granulomas in cardiac tissue can only be spotted through advanced imaging techniques, you can also be on the lookout for signs of sarcoidosis on the skin, which can appear as red, brown, or purple areas [6]. It may be oval in shape and possibly scaly. A dermatologist can assist with diagnosis!

A Pink, Painless Rash (Erythema Marginatum)

Erythema marginatum can be defined as a non-painful, non-itchy rash that could be flat or slightly elevated. It’s typically pinkish in color and found on the torso, and sometimes the extremities. The rash is temporary, but could point to rheumatic heart disease.

Rheumatic heart disease is a disorder caused by rheumatic fever, which can be triggered by a streptococcal bacterial infection (aka strep throat). You might have strep throat or scarlet fever that hasn’t been treated with antibiotics, then years later (sometimes even decades later), you develop rheumatic heart disease [7].

Not everyone who has rheumatic fever will develop rheumatic heart disease, but about 60 percent will [7]. Fortunately, antibiotics can stop strep throat from turning into rheumatic fever. 

For those that do develop rheumatic heart disease, the heart valves will likely be affected, particularly the mitral valve on the left side of the heart. It can lead to damage to the heart muscle or narrowing of the valve [7]. Rheumatic heart disease is rare is developed countries.

Swelling (Edema)

Edema is defined as fluid collecting in various parts of the body due to an underlying condition. Edema, which could present as swollen hands, feet, or legs, could be a sign of congestive heart failure. 

The swelling happens when capillaries—which are the smaller blood vessels in your body—begin to leak fluid. In cases where congestive heart failure is present, the heart’s lower chambers may not be able to pump blood as well, which can cause blood to accumulate in the lower extremities.

However, congestive heart failure can also cause fluid to accumulate in the stomach and even the lungs [8]. While edema can have many causes, it’s worth checking with your doctor to be sure your heart isn’t the issue!

Red Lips and Tongue (Strawberry Tongue)

Kawasaki disease is a rare disorder that affects children, and its symptoms can present as red lips and what’s called a “strawberry tongue”, in which the tongue appears red and bumpy. 

This condition is typically accompanied by fever, rash, swelling of hands and feet, and swollen lymph nodes in the neck. While usually not serious—most children make a full recovery—Kawasaki disease can lead to chronic heart complications [9].

It’s estimated that one in four children who have Kawasaki disease will sustain damage to the blood vessels surrounding the heart and a weakened coronary artery [9].

If your child has strawberry tongue and red lips accompanied by a fever, rash, and swelling of the hands and feet, don’t hesitate to seek medical treatment!

Discolored Areas on the Skin (Janeway Lesions and Osler Nodes)

Janeway lesions, which are non-painful discolored areas on the skin, typically located on the palms and the soles of the feet, are usually indicative of an infection of the inner lining of your heart chambers and valves [10]. This condition is called endocarditis. 

Osler nodes are also associated with endocarditis, but unlike Janeway lesions, are tender, raised, red-purple, and may have a pale middle. They’re usually found on the fingers and toes, and can last for hours or days [11].

Getting either of these dermatologic conditions checked out is imperative, as endocarditis can be fatal. Acute endocarditis—in which you may have a sudden high fever, rapid heart rate, and fatigue—has a high mortality rate [12].

Always Seek Medical Advice If You Suspect a Problem!

Have you heard of the above symptoms as signs that something’s amiss with the heart? As always, follow up with your experienced healthcare practitioner if you suspect you’re seeing any of the above signs or experiencing cardiac symptoms.

A dermatologist should be able to effectively diagnose your skin concerns, but if you’re having severe or alarming symptoms such as chest pain and shortness of breath, don’t hesitate to seek emergency medical care!

Disclaimer: This information is not intended to be a substitute for professional medical advice, diagnosis or treatment and is for information only. Always seek the advice of your physician or another qualified health provider with any questions about your medical condition and/or current medication. Do not disregard professional medical advice or delay seeking advice or treatment because of something you have read here.

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Jenn Ryan
Health Expert
Jenn Ryan is a freelance writer and editor who's passionate about natural health, fitness, gluten-free, and animals. She loves running, reading, and playing with her four rescued rabbits.

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