Dr Alex Wibberley has warned that needing extra pillows to sleep comfortably could be a sign of orthopnea — one of several subtle early warning signs of heart disease that are commonly missed. Orthopnea is a shortness of breath that occurs when lying flat but disappears upon sitting or standing upright. Those affected may also experience a dry cough or wheezing while lying down that subsides when sitting up.
Why Extra Pillows Can Be a Red Flag
As people age, everyday activities such as climbing stairs or carrying shopping bags can become more difficult. However, slight breathlessness could be an early warning sign of a serious underlying health condition. Dr Wibberley explains on his Doctor Alex YouTube channel that the condition is one of several subtle warning signs of a future heart attack that frequently go unnoticed. Each of these signs can ultimately be linked to a stiffening of vital blood vessels, which places additional strain on the heart.
When the heart is compelled to work harder, like any other muscle, it will thicken over time to handle the strain. While a more muscular heart can squeeze forcefully enough to maintain normal blood flow, it typically struggles during the relaxation phase between beats. This struggle is easily overlooked. Dr Wibberley notes, 'This doesn't show up on a routine ECG, it won't be caught in a standard GP check. But it shows itself in daily life.'
Subtle Signs Often Mistaken for Aging
Dr Wibberley points out that the earliest indicators of cardiovascular disease are 'pretty boring,' which is precisely why they are so frequently missed. They can be mistaken for the consequences of having several hectic days, becoming slightly unfit, or simply aging. 'That is exactly what makes them dangerous,' he says. 'Take tiredness for example... the unusual fatigue after climbing just one flight of stairs.' He emphasizes that this is not the sort of thing many people will comment on; they simply accept it as par for the course with getting older.
Dr Wibberley adds, 'People start sleeping with an extra pillow without really consciously deciding to. They just find themselves more comfortable when they're slightly upright.' Fluid that has accumulated in your legs throughout the day will redistribute itself once you have been lying horizontal for a period. Particularly, it will migrate to your chest and begin placing pressure on your lungs. 'In emergency departments, that is a big red flag for heart failure... in somebody's house, it's just an extra pillow, but to [emergency room doctors] that means something,' he explains.
Window for Prevention Is Years Wide
The encouraging news about these early warning signs is that they present a chance to prevent a future heart attack. 'This window for changing this trajectory is really big. It's years wide,' Dr Wibberley continues. Exercise and diet are dependable methods for improving heart health. 'When you do sustained rhythmic movement – like walking briskly, or cycling, or swimming, or rowing – the increased blood flow creates mechanical friction against the blood vessel wall.' That friction encourages the body to produce more nitric oxide, the essential molecule that fights vascular inflammation and reduces blood pressure by relaxing and widening blood vessels.
'Studies have shown this happening within weeks, not months or years, of starting exercise,' he adds. 'The biology is more responsive than most people expect.' Reducing carbohydrate intake also has a beneficial effect on heart health. Alongside monitoring blood pressure, these are straightforward, accessible steps anyone can take to lower the risk of serious heart disease.
The NHS also provides comprehensive advice on symptoms of cardiovascular disease and guidance on how to reduce your risk of developing it.
