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You wake up one morning with a fever. Or maybe you have a really bad neck ache. How do you know if a symptom is serious or not? “The things that we doctor are most concerned about are new symptoms that develop quickly, rather than things that develop over a long period of time,” says Keith L. Black, M.D., chair of neurosurgery at Cedars-Sinai Medical Centre in Los Angeles.

Another warning signs? That uh-oh feeling that tells you something’s not quite right. “You know your body best,” says Len Lichtenfeld, M.D., deputy chief medical officer at the American Cancer Society. “When you see or feel something different or just feel ‘off,’ pay attention; don’t dismiss it.”

Here are nine symptoms and what they might mean:

1. Sudden Intense Headache

The big worries

If you experience head pain unlike any you’ve had before, especially if it peaks in seconds to minutes in any part of the head, it could signal a ruptured aneurysm; a blood vessel in your brain that suddenly bursts, requiring immediate attention.

What else it might be

Shingles can cause pain in the forehead before the notorious skin reaction (shingles is a painful flare-up of the herpes zoster virus that lies dormant in anyone who’s had chickenpox). Contrary to common belief, sudden severe headaches are unlikely to be a sign of a brain tumour. Rather, research shows that two-thirds of patients diagnosed with a brain tumour experienced tension headache — dull, achy or pressure-like pain — that steadily worsened over a period of weeks to months.

2. Chest Pain

The big worries

Any intense discomfort, heaviness or pressure — like an elephant sitting on your chest — could spell heart attack. It may be combined with pain radiating down an arm, nausea and vomiting, sweating, and shortness of breath. Women can experience more subtle symptoms, like fatigue, a burning sensation or upper abdominal pain.

“If it is a heart attack, a delay could cause the heart muscle to be damaged,” says Eric Topol, M.D., a cardiologist at the Scripps Clinic in La Jolla, California. If these symptoms occur only during exertion, it could also be angina, which happens when the heart muscle temporarily doesn’t get enough blood.

Sudden severe chest or upper-back pain (often described as a ripping sensation) can be caused by a tear in the aorta, known as aortic dissection, which requires immediate attention. Fortunately, this life-threatening condition occurs in only about three out of 100,000 people.

What else it might be

“Perhaps 10 to 20 per cent of cases of intense chest pain are due not to heart trouble but to [GERD],” says Topol. Rarely, it could also signal oesophageal spasm, an abnormal contraction of the muscles in the oesophagus, which carries food from the throat to the stomach. Both conditions can be treated with medications, but it’s always wise to go to the ER: “It’s a heart attack or angina until proven otherwise,” Topol says.

3. Unexplained Weight Loss

The big worries

Losing more than 5 per cent of your body weight — without trying — over a period of six months could mean cancer: Weight loss is a symptom in up to 36 per cent of cancers in older people.

“If you or a family member is suddenly losing weight after trying 400 times before, you have to ask, ‘Why is this time the charm?’ ” says Lichtenfeld.

What else it might be

Endocrine disorders are a common cause of unintentional weight loss. Of those with an endocrine disorder (especially hyperthyroidism, an overactive thyroid), up to 11 per cent experience weight loss. The condition also triggers restlessness, sweating, increased appetite and difficulty concentrating.

If your weight loss is accompanied by extreme thirst or hunger, fatigue and frequent urination, it could be a sign of diabetes.

Gastrointestinal conditions like inflammatory bowel disease and celiac disease cause weight loss as well — in addition to symptoms such as diarrhoea and abdominal pain.

Depression and other psychiatric conditions could be to blame, too. “Decreased appetite and weight loss are very common symptoms of depression,” says Susan G. Kornstein, M.D., professor of psychiatry and obstetrics/gynaecology at Virginia Commonwealth University. “But patients with unexplained weight loss should undergo a workup to rule out general medical causes.”

4. Swelling in the Legs

The big worries

An accumulation of fluid (called edema) in the extremities can be caused by a number of conditions, but the one that most concerns doctors is heart failure when the heart cannot pump as much blood as the body needs. When that happens, blood backs up in the veins, causing fluid to accumulate in the body’s tissues.

“Swelling of the legs, especially if it is persistent, should never be ignored,” says Gordon F. Tomaselli, M.D., director of the division of cardiology at the Johns Hopkins University School of Medicine in Baltimore. Heart failure is suspected when both legs are affected and the patient also has shortness of breath, fatigue and chest tightness.

What else it might be

A vein problem known as venous insufficiency can also cause swelling. Normally, valves in the leg veins keep blood flowing back to the heart, but in those with venous insufficiency, these valves are weakened, causing a backup of blood. “If valves are the problem, swelling usually goes away when you lie down,” Tomaselli says. Compression stockings can help. Swelling can also result from hypothyroidism (not enough thyroid hormone).

5. Sudden or severe abdominal pain

The big worries

Sudden abdominal pain could signal that an aortic aneurysm — a bulge that develops in the aorta, frequently in the abdominal area — has ruptured.

“If an aneurysm ruptures, the pain tends to be sudden and severe and typically centralized around the belly button,” says Richard Desi, M.D., a gastroenterologist with Mercy Medical centre in Baltimore.

Alternatively, sudden pain can indicate a perforated viscus (a hole in the stomach, intestine or other hollow organs), often due to an ulcer. Intestinal ischemia, which happens when blood flow to the intestines slows or stops, starving tissues of oxygen, can be a culprit, too. “It’s more common in older, sicker patients who have heart failure or atrial fibrillation,” says Brian Putka, M.D., a gastroenterologist with the Cleveland Clinic. Each of these conditions is life-threatening, requiring emergency surgery.

What else it might be

Abdominal pain is frequently due to gallstones, which are hard, pebblelike deposits that get lodged in a gallbladder duct, resulting in sharp pain as well as nausea and vomiting. Diverticulitis — inflammation or infection in small pouches of the large intestine — can be another cause of sudden, severe pain, along with changes in bowel habits, fever and nausea. Although irritable bowel syndrome can trigger painful spasms in the colon, the pain tends to come and go over time and may also cause constipation, diarrhoea or alternating bouts of both.

Appendicitis is a less likely candidate for sudden abdominal pain in those over 50, as the condition is less common with age. When it does occur, however, expect gradually worsening pain in the right-lower quadrant of the abdomen.

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