The skin is the most visible organ in the entire body and all systemic disease has a cutaneous manifestation or has manifestations on the skin. This means that there are clear signs that allow the internal disease to be identified through the changes observed in the skin.

The signs of heart disease that appear on your skin are so characteristic and universal that after learning them you will be able to identify them very easily.

What is heart disease?

Under the name of heart disease all abnormal conditions or conditions that affect the heart are grouped, regardless of their cause or the alteration they produce. In simple terms, heart disease causes the body’s tissues to not receive adequate oxygenation , which can accumulate fluids or infarct the tissues.

Signs of heart disease that appear on your skin

Your dermatologist or GP will most likely identify heart disease by findings and changes in your skin, even early before you experience all the symptoms of the disease. Signs of heart disease that appear on the skin are:

  • Edema . It is the inflammation or increase in volume caused by the accumulation of fluid. When this swelling occurs in the feet and ankles or the lower part of both legs, it is a classic sign that the heart is not working properly, caused by being unable to pump or move blood through the body.
  • Cyanosis . Cyanosis is the term used to describe the bluish or even purple discoloration of the skin. This coloration is indicative that the tissues are not receiving enough oxygen, caused by not receiving adequate blood flow. By not receiving enough oxygen, the affected tissue becomes necrotic or the tissue will infarct and stop working.
  • Web-shaped patterns or spider webs . The external blood vessels of the skin can be easily appreciated when the correct circulation of blood through them is being impeded, or when they must be markedly dilated. A web-like pattern or spider web on the skin of the arms, legs, and abdomen is exhibited in some patients. (Observing this network during intense cold and for a short time is normal)
  • Marbled skin (Livedo reticularis) . It means that in the skin of the lower limbs there are areas with a coloration that ranges from slightly red to intense purple, with a pattern of a fishing net (the area with changes in red or purple corresponds to the hollow or free part of this net and threads would be the uncolored part). This is caused by a blockage of the blood vessels. When the pattern is very intense, it is usually due to cholesterol plugs that have clogged the blood vessels in the area.
  • Xanthomas . They are yellowish or orange areas on raised, rounded, located in the outer layers of the skin caused by deposits or the accumulation of cholesterol. These are common on the eyelids and soles of the feet of patients with high levels of lipids (fats) in the blood or problems with cholesterol metabolism.
  • Drumstick fingers (clubbing) . Also known as Hippocratic fingers, it is a thickening of the skin under and around the nails that does not cause pain or sensitivity. This alteration is caused by the chronic lack of oxygen to the tissues.
  • Terry’s   nails (half and half nails). The nails have a characteristic double coloration, the lower two thirds will be white and the upper third will be red. By exerting pressure on this area, the coloration disappears, returning after a few seconds that the pressure is released. This type of sign is present in patients with heart failure.
  • Splinter hemorrhages under the nails . Suddenly appearing red or purple lines or dots under the nails on several fingers are characteristic of a life-threatening infection of the inner tissue of the heart, called endocarditis. These lines must be accompanied by intense fever and difficulty breathing, since they are an emergency, they must be evaluated in the emergency room.
  • Increased abdominal diameter or Ascites . The sudden increase, in a few days, in the abdominal circumference can be caused by a failure of the heart as a pump, which causes an inadequate blood flow.

Significance of the skin manifestation of heart disease

The skin has the ability to react to most systemic diseases. The significance of the skin manifestations of heart disease is relative and can only be understood when the causes of heart disease have been diagnosed. These changes can be used to indirectly measure the success or failure of a treatment or the progression of the disease.

By Dr. Eric Jackson

Dr. Eric Jackson provides primary Internal Medicine care for men and women and treats patients with bone and mineral diseases, diabetes, heart conditions, and other chronic illnesses.He is a Washington University Bone Health Program physician and is a certified Bone Densitometrist. Dr. Avery is consistently recognized in "The Best Doctors in America" list.

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