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"If only I had known."

That thought is common to many of Dr. William Baker's cardiology patients as they look back and realize they failed to recognize some early symptoms of their heart disease.

Nationally, more than half of the people who have cardiovascular disease are diagnosed only after they have had a heart attack.

Baker, a Steamboat Springs cardiologist and medical director of Yampa Valley Medical Center's cardiovascular services, would like to lower that statistic in this region.

He feels education is the key to awareness, prevention, early detection and effective treatment of this life-threatening disease.

"Shortness of breath, fatigue, lightheadedness and even chronic indigestion that doesn't get better with treatment can all be warning signs of cardiovascular disease," Baker said.

"I hear patients say, 'I used to hike up Howelsen Hill or walk up the steps with my laundry, but now I can't do it, I just feel wiped out.' People say they could do things two months ago that they can't do now."

The most common type of cardiovascular disease is coronary artery disease, Baker said. During physical exertion, more is being demanded of the heart, which beats stronger and faster and isn't up to the challenge.

Another widespread disease is atrial fibrillation, which usually causes a rapid or irregular heartbeat. However, Baker said, sometimes people don't feel palpitations or irregularity, so they don't know that anything is wrong.

"Shortness of breath and a light-headed feeling are often clues to atrial fibrillation," he said.

Why are symptoms such as shortness of breath and fatigue so easily ignored?

"A lot of people assume they're having these problems because they are aging, they have put on some extra weight, or they are out of shape," Baker said. "When we discover that the real cause is heart disease, people say, 'I just thought I was getting older.'"

Certainly not everyone who feels tired has heart disease, Baker cautioned. But a noticeable change in stamina within a few weeks or couple of months should prompt a visit to the doctor.

"Many people can tell when something is just not right with their bodies," Baker said. "We want to identify heart disease before it results in a heart attack, which can be fatal or cause irreversible damage to the heart muscle.

"You need to be in touch with how you feel and be persistent if you think something is wrong," he added. "If you're not feeling well, get an evaluation. If you don't feel better with treatment, be persistent and seek answers from your physician or a specialist."

Heart disease sometimes takes many years to develop. A primary cause is the buildup of cholesterol plaque inside the arteries, called atherosclerosis. This can start to develop during teenage years, Baker said.

Some people can manage their risk factors successfully by controlling their cholesterol and blood pressure, exercising regularly and watching their diet. Two risk factors that cannot be controlled are aging and family history of cardiac disease.

"The older you get, the more concerned you should be," Baker said. "And be very aware if you have a combination of risk factors, such as high blood pressure, high cholesterol, smoking, diabetes or a strong family history of heart disease or stroke, particularly at a younger age."

If you're waiting to have chest pain before thinking you may have heart problems, you may be waiting too long and waiting for the wrong sign.

When a heart attack does occur, it may not feel like chest pain, Baker said. Instead, many people describe a feeling of heaviness, discomfort, pressure or tightness in the chest. Additionally, there may be pain in the neck, jaw or back, unusual areas of discomfort, nausea or sweating.

"Any one of these symptoms is worrisome, and a cluster is usually a sign of a serious problem and the need for immediate medical attention," Baker said.

"But ideally, we would like to detect heart disease before it causes a heart attack. That's why education, early detection and prevention are so important."

Christine McKelvie is public relations director of Yampa Valley Medical Center. She can be reached at christine.mckelvie@yvmc.org.