Another characteristic of heart disease is that one's breathing is worse when they lay flat. Patients with heart disease often have to sleep with their head elevated on many pillows. Some can only sleep sitting up in a chair. Swelling of the ankles is most commonly caused by varicose veins in the legs but can also be a manifestation of heart disease. One should be especially concerned about heart disease if the swelling occurs in association with shortness of breath.
Palpitations refers to an awareness of the heart beating.
This sensation may be entirely normal if it only occurs with physical exertion or emotional stress. It is also common for people to be aware of their heart beat when they lay down to go to sleep at night. Some people can actually hear their heart beating when they lay in bed with one ear pressed against the pillow and that is also normal. Palpitations should be brought to the doctor's attention especially when they are associated with other symptoms, such as dizziness or lightheadedness. Fainting is never normal.