The main cause of death globally is still heart disease. Heart attacks may occur suddenly without any warning signs. However, in the film industry, intense chest pain would be portrayed for a heart attack. In actuality, many patients have slight symptoms that go unnoticed until the time of their heart attack days or even weeks prior to that.

Heart attacks do not always announce themselves with dramatic chest pain. Often, they manifest in subtle, easy-to-dismiss ways. Recognizing these overlooked warning signs and taking proactive steps toward cardiovascular health can save lives. If you or someone you know experiences any of these symptoms, seeking immediate medical care is crucial. Prioritizing heart health today can help prevent life-threatening complications in the future.

Warning Sings of A Heart Attack

1. Discomfort Pressure in the Chest

One of the earliest and most common warning signs of an impending heart attack is pressure, tightness, or fullness in the chest. This pain is not typically sharp and sudden, like most people associate with a heart attack, but it can be intermittent, coming in waves, and lasting for several minutes before fading away. According to the American Heart Association, this is one of the red flags when accompanied by exertion. If you have persistent chest pressure, you should call emergency services immediately.

2. Pain Radiating to Other Parts of the Body

The well-known symptom of chest pain can also manifest discomfort related to a heart attack as pain radiating to other parts of the body. It is not unusual for people experiencing this kind of heart attack to report feeling pain in the shoulders, arms, back, neck, and even jaw. The vagus nerve is one that connects the heart to the brain, abdomen, and neck. The pain may be referred to these regions. In case you experience a sudden, unexplained pain in these regions, especially when exercising, seek a doctor's opinion.

3. Dizziness and Lightheadedness

Feeling dizziness upon standing up quickly or missing a meal is common, but unexplained dizziness often with chest pain or shortness of breath is the first sign of heart attack. Sudden hypotension can seriously decrease the blood supply to the brain and cause dizziness. Dizziness that does not go away on its own should not be ignored.

4. Unexplained Fatigue

It often happens that excessive tiredness, particularly in a busy lifestyle, is considered trivial, but ongoing fatigue, mostly in women, is a predictor of heart failure. According to some studies, extreme fatigue often starts a month before a heart attack, primarily in women. This is simply because the heart cannot pump well enough, leaving insufficient oxygen available to muscles and organs. Consult a healthcare professional if you become increasingly tired over time, yet are getting all the rest in the world.

5. Nausea, Indigestion, or Stomach Pain

Digestive problems like nausea, vomiting, or indigestion are often mistaken for acid reflux or food poisoning. However, these symptoms can also indicate reduced blood flow to the digestive tract, a common precursor to heart attacks. If you experience gastrointestinal distress alongside other symptoms like dizziness or chest discomfort, it's important to seek medical advice immediately.

6. Cold Sweats and Excessive Perspiration

Without apparent reason, a heart attack might be signaled by sudden sweating without any exercise or hot weather conditions. The heart's inability to function properly creates the body's "fight or flight" reaction, which means excessive sweating will occur. Be aware of your body and never ignore a cold sweat, particularly if it coincides with other symptoms.

7. Heart palpitations or irregular heartbeat

A racing or irregular heartbeat can be a normal reaction to stress or caffeine consumption. However, regular or unprovoked heart palpitations may indicate that the heart is under duress. If the heart is not getting enough oxygen-rich blood, it can start to beat irregularly. If you experience palpitations along with dizziness, chest pain, or shortness of breath, you should see a doctor right away.

8. Shortness of Breath

If suddenly climbing stairs or performing other everyday activities becomes a problem, then there may be a heart issue. Shortness of breath usually occurs with heart conditions because the circulation is not adequate and less oxygen is provided to the lungs. This symptom can occur either with or without chest pain and is an important indicator of the presence of underlying heart disease. If you find yourself experiencing sudden unexplained breathlessness, then seek a healthcare provider as soon as possible.

When to Seek Medical Attention

Early detection of these symptoms and early intervention can help avoid a life-threatening heart attack. You should visit a doctor if you feel the following symptoms:

• Symptoms induced by exertion and relieved by rest
• The simultaneous onset of several warning signs, including weakness, dizziness, and nausea
• Personal or family history of heart disease, hypertension, diabetes, or smoking

Preventing Heart Attacks: Proactive Steps for Heart Health

Although heart attacks may come out of nowhere, lifestyle plays an important role in reducing a patient's risk; here are some heart-healthy habits to consider:

Take on a Heart-Healthy Diet: Focus on consuming whole foods, lean proteins, healthy fats, and fiber-rich fruits and vegetables. Try to limit processed foods, saturated fats, and added sugars.

Stay Active: Engage in at least 30 minutes of moderate physical activity most days of the week to strengthen your heart and improve blood circulation.

Smoking. Smoking is probably the single largest risk factor for heart disease. If you are a smoker, quitting can easily be the single best thing you can do to improve your heart health.

Deal with Stress: Chronic stress leads to heart disease. Relaxed people through various relaxation techniques including yoga, meditation, and even deep breathing, have lesser stresses.

Regular health checks Monitor blood pressure, cholesterol levels, and blood sugar on a regular basis. The risk factors' early detection can help avoid serious complications.

Climate change and rapid urbanization are changing mosquito habitats, and shifting dengue serotypes are reshaping the disease landscape in India. As a result, the country is now witnessing a transformation in how dengue spreads, who it affects, and how severe infections can become.

Once considered a seasonal monsoon illness, dengue is now increasingly becoming a year-round public health challenge, extending into hill states, semi-urban regions, and previously low-risk geographies.

In an exclusive interview with HealthandMe, Dr. Shikha Taneja Malik, Senior Scientific Affairs Manager, Drugs for Neglected Diseases initiative (DNDi), South Asia, discussed why India’s dengue numbers are likely being massively undercounted, how surveillance and diagnostic gaps are masking the real scale of the crisis, and why young adults are facing more severe infections due to changing serotypes.

Dr. Shikha also explained the urgent global push for affordable therapeutics and the challenges India still faces in developing an indigenous dengue vaccine despite its strong manufacturing capacity.

Here are the excerpts from the interview:

Q. Dengue was always called a monsoon disease. Is that label now dangerously misleading?

Dr. Shikha: Yes, I would argue that labels are not just outdated but risky, too. What we are seeing across India and across the region is a fundamental shift in the transmission pattern.

Dengue used to follow a fairly predictable seasonal curve — cases would spike between July and November, track the monsoon, and then recede. That curve is flattening. We are now seeing cases in February, March, and May — months that were previously considered safe. Delhi, Mumbai, Bengaluru — cities that used to have clear off-seasons for dengue — are reporting year-round transmission.

Warmer temperatures, altered rainfall patterns, unplanned urbanization, and poor sanitation have lengthened transmission seasons, making dengue a year-round systemic crisis. Models now predict year-round transmission in coastal regions, though monsoon months will retain the highest peak.

Also read: National Dengue Day 2026: India Reports 6,927 Cases And 10 Deaths In 2026

Q. Are serotype shifts driving changing dengue patterns, especially in young adults?

Dr. Shikha: Yes, India is witnessing active serotype shifts, and they directly explain rising severity, especially in young adults. Initial infection with one of the four dengue serotypes results in lifelong immunity to that specific serotype. Whereas, a secondary infection with a different serotype can trigger Antibody-Dependent Enhancement (ADE).

Young adults who were exposed to one serotype in childhood are now encountering a new dominant serotype, making them especially vulnerable to severe secondary infections.

Q. Is India undercounting dengue cases? Why do so many cases go unreported?

Dr. Shikha: The 2.89 lakh figure in 2023 is what our surveillance system captures, but it is almost certainly a fraction of the true burden. The Lancet has estimated that India accounts for around 33 per cent of the global dengue burden, and globally, we are looking at approximately 400 million infections every year. That puts India's real annual dengue burden potentially in the tens of millions — not hundreds of thousands.

Few studies have shown that the estimates of actual cases are approximately 282 times higher.

There are several reasons why cases go unreported, and they compound each other.

• A large proportion of infections are either asymptomatic or present as a generic fever — patients never seek formal care.
• Our surveillance system is passive and fragmented. Reporting is largely dependent on public health facilities.
• Confirmatory testing through NS1 antigen tests or PCR requires infrastructure that is not yet uniformly available at the primary health center level, particularly in rural and semi-urban areas.

Q. Are previously dengue-free regions in India now reporting cases due to climate change?

Dr. Shikha: Yes, the geographic spread is both significant and well-documented. Climate change is playing a major role in this shift. Rising temperatures, changing rainfall patterns, increasing humidity, and rapid unplanned urbanization are creating more favorable conditions for Aedes aegypti mosquitoes to survive and transmit the virus for longer periods each year.

Since the mid-1990s, dengue has rapidly spread to regions where it was historically non-existent, including Odisha, Arunachal Pradesh, and Mizoram. In the early 2000s, dengue was endemic only in a few southern and northern states; it has since spread to many states, including union territories.

Read More: Ebola Outbreak: Rare Bundibugyo Strain Confirmed In DR Congo And Uganda

The shift is particularly visible in hilly and cooler geographies such as Himachal Pradesh and Jammu & Kashmir. Climate modelling projects further expansion of Aedes albopictus into upper Himalayan regions, including Leh-Ladakh and Arunachal Pradesh, by 2050.

Q. What are the biggest challenges in indigenous dengue vaccine production in India?

Dr. Shikha: India has strong vaccine manufacturing capacity, but dengue remains scientifically complex. Existing vaccines have limitations and do not cover all vulnerable groups.

India’s first Phase 3 trial for an indigenous dengue vaccine, DengiAll, is underway across 18 states. The Butantan vaccine candidate, originally developed by NIH, has been licensed to Indian companies, including Panacea, SIIPL, and Indian Immunologicals, with the ICMR-Panacea candidate being the most advanced.

The recent DCGI approval of Qdenga is encouraging, but sustained financing and coordination between ICMR, DBT, and industry will be critical for developing a truly indigenous vaccine.

Dengue has become one of the fastest-emerging health crises in the urban parts of India. Every year during the monsoon season, the number of dengue cases rises dramatically in many Indian cities, posing a huge burden on the healthcare sector.

Though climate and mosquitoes are usually cited as reasons for the surge in dengue cases, the problem actually lies in how urban life and the infrastructure of the cities have changed over the decades.

Why Urban Areas Are More Vulnerable

The dengue virus is spread through the Aedes aegypti mosquito that lives well in fresh still water, which is abundant in urban areas.

Mosquitoes breed in construction sites, open water tanks, old plastic buckets, flower pots, coolers, water stored on roofs, and blocked drainage systems. Due to the growing size of cities and high population density, mosquito-borne diseases have become more common.

There are many factors that contribute to the rise in the number of dengue patients, one of which is unplanned city expansion. The fast pace of development in the cities results in stagnant water in the construction areas going unnoticed for weeks.

Moreover, improper drainage and a lack of sanitation facilities help mosquitoes breed. Even posh societies and offices can suffer if proper checks are not conducted.

Urban lifestyle trends also act as indirect factors contributing to the issue. Longer working hours, higher levels of indoor activities, and reliance on mechanical ventilation lead to less focus on environmental hygiene issues.

Families tend to take mosquito prevention steps only after an outbreak starts. The overuse of plastics and poor waste management practices in urban areas have exacerbated waterlogging problems.

The situation has been exacerbated by climate change and global warming. Mosquitoes can breed at a faster pace and survive for a longer period of time in the warm climate and unpredictable rain patterns. Another factor that plays an important role is urban heat islands, which refer to places that are hotter because of man-made concrete buildings.

What Needs to Change?

In order to curb the incidence of dengue, there must be an all-around transformation, both on the part of the governing authorities and the people. Firstly, urban planning should take into consideration good drainage facilities, frequent fogging, garbage disposal services, and proper regulation of building sites. Secondly, there must be frequent checks in residential areas, schools, offices, markets, and open public areas.

Secondly, the awareness campaign needs to be practical and more community-oriented. The citizens should realize that the prevention of dengue starts from their homes. Actions like washing the coolers once a week, covering the water tank, not allowing the water to stagnate, and using mosquito repellents will go a long way in minimizing the spread of dengue.

Early Detection and Healthcare Preparedness

Healthcare preparedness is also equally important. The early detection and proper treatment of dengue could help avoid any serious complications. One should never overlook symptoms like fever, body pain, headache, rashes on the skin, nausea, and weakness during the rainy season.

Combatting dengue fever is no longer just a matter of health care but rather a question of urban planning and lifestyle issues. As the cities continue to expand, everyone should unite and come up with healthier and more environmentally friendly cities. Otherwise, we may see more recurring problems of dengue outbreaks in urban settings every year.

Amid growing discussions around hantavirus transmission through body fluids, experts today stressed that cases involving transmission through breast milk or semen remain extremely rare and should not trigger unnecessary panic.

The discussions began after a 2023 study published in the journal Viruses found that the Andes strain of the rat-borne virus can persist in human semen for up to six years.

More concerning was the possibility that the virus could potentially be transmitted sexually even after a person has recovered, according to the peer-reviewed study.

The research, conducted by Swiss scientists at Spiez Laboratory, suggested that hantavirus may survive in the male reproductive tract like viruses such as Ebola.

“Taken together, our results show that the Andes virus has the potential for sexual transmission,” the study said. However, to date, no confirmed case of such transmission has been documented.

Why Viral RNA Can Persist In Semen

Speaking to HealthandMe, Dr. Rajeev Jayadevan, convenor of the IMA research cell, explained that the detection of Andes virus RNA — the hantavirus strain linked to the recent MV Hondius cruise ship outbreak — in semen long after recovery is not entirely unexpected.

“The finding of RNA belonging to the Andes virus in human semen long after recovery is no surprise. In fact, this is a well-described scenario in at least 27 different viruses, including Zika and Ebola,” he said.

He explained that viruses reaching the testis enter what is known as an “immune-privileged” site protected by the blood-testis barrier (BTB).

“The testis is naturally shielded from the body’s immune system to protect newly formed sperm cells from being recognised and destroyed as ‘foreign’,” Dr. Rajeev said.

According to the expert, many viruses take advantage of this natural immune protection, allowing them to remain in the area longer than expected.

However, he clarified that although researchers detected viral RNA in semen, the virus itself could not be cultured, meaning there is no proof that the infectious virus remained present.

Also read: Ebola Outbreak: Rare Bundibugyo Strain Confirmed In DR Congo And Uganda

Can Hantavirus Spread Via Breast Milk?

Another study published in Emerging Infectious Diseases, a monthly open-access peer-reviewed medical journal published by the US Centers for Disease Control and Prevention, highlighted the risk of mother-to-child transmission of the Andes strain of hantavirus through breast milk.

Andes virus (ANDV) is the only hantavirus known to spread between humans through close contact.

“We detected the genome and proteins of ANDV in breast milk cells from an infected mother in Chile who transmitted the virus to her child, suggesting gastrointestinal infection through breast milk as a route of ANDV person-to-person transmission,” the study said.

Epidemiologist Dr. Amitav Banerjee, professor at DY Patil Vidyapeeth, Pune, told HealthandMe that while isolated cases of hantavirus transmission from mother to child through breast milk have been reported, they are highly uncommon.

“These cases of hantavirus transmission through breast milk from mother to child are very rare. As a general rule, there is no need to worry excessively,” he said.

According to him, mothers experiencing fever during the acute stage of illness may temporarily avoid breastfeeding because viral load tends to be highest during active infection and just before symptoms appear. However, he stressed that breastfeeding should not be stopped routinely out of fear.

Dr. Amitav explained that the situation is somewhat comparable to HIV transmission through breast milk, which also occurs in less than 1 percent of cases. Despite that, mothers in many developing countries are still advised to continue breastfeeding because the health risks of depriving infants of breast milk are often greater than the risk of viral transmission.

He noted that hantavirus differs significantly from HIV because it is generally an acute and transient infection, unlike HIV, which persists lifelong in body fluids.

“Hantavirus infection is acute and transient, whereas HIV is lifelong,” he said, adding that hantavirus usually clears from the body after recovery, including from semen and other body fluids.

Sexual Transmission After Recovery Still Unclear

Dr. Rajeev noted that the Andes virus spreads primarily through close contact and shared personal space while a patient is symptomatic.

“Whether it can be sexually transmitted long after recovery remains unknown,” he said.

Overinterpreting RT-PCR Results

Dr. Amitav also cautioned against overinterpreting isolated reports of viral detection in semen or breast milk.

According to him, RT-PCR tests are extremely sensitive and may detect dead viral particles even after the infection has resolved. Therefore, a positive RT-PCR result does not necessarily mean that a person remains infectious.

“In fact, RT-PCR is highly sensitive and often used more for research and surveillance purposes. Detecting viral material does not always indicate active infection or transmission risk,” he said.

He added that hantavirus does not appear to persist as an infectious virus for a long period after recovery and that there is currently no strong evidence supporting long-term transmission once a patient has recovered.