New Delhi: Feeling tired has almost become a default state. People wake up exhausted, struggle through the day, and assume it is the price of modern life—long work hours, constant screens, poor sleep, stress. While all of these certainly play a role, persistent or disproportionate fatigue deserves closer attention. In many cases, tiredness is not just about lifestyle. It can be an early signal of an underlying medical problem, including heart disease.
In an interaction with News9Live, Dr. Suman Chatterjee – Cardiologist, BM Birla Heart Hospital, explained why constant and chronic fatigue is a reason to worry about.
From a clinical standpoint, fatigue is one of the most common but least discussed symptoms patients report. It sits at the intersection of physical and mental health. Emotional stress, anxiety, depression, sleep disorders, and burnout can all cause overwhelming tiredness. At the same time, several medical conditions present primarily as easy fatigability—long before more obvious symptoms appear.
When tiredness feels “inappropriate”—out of proportion to activity levels, worsening over time, or interfering with daily functioning—it often points to an organic cause. Anaemia, for example, is a frequent and easily missed reason, especially in women. Reduced oxygen-carrying capacity means the body has to work harder for routine tasks, leading to constant exhaustion.
From a cardiologist’s perspective, the expert said, one trend is increasingly concerning: coronary artery disease (CAD) presenting as fatigue rather than chest pain. Traditionally associated with older adults, CAD is now being seen in younger and middle-aged individuals who otherwise consider themselves active and healthy. Many of them do not complain of classic symptoms. Instead, they notice a drop in stamina, breathlessness on exertion, or an inability to recover after routine physical activity.
Lifestyle factors play a major role here. Sedentary work patterns, smoking, poor dietary habits, unmanaged stress, and lack of regular exercise quietly accelerate vascular disease. Over time, reduced blood flow to the heart muscle limits its efficiency. The result is not always pain, but a persistent sense of tiredness that no amount of rest seems to fix.
Coronary artery disease is not the only cardiac condition where fatigue dominates the picture. Valvular heart diseases can reduce effective circulation, cardiomyopathies can impair the heart’s pumping capacity, and pulmonary hypertension places excessive strain on the right side of the heart. In all these conditions, fatigue is often the earliest symptom patients notice, long before swelling, palpitations, or overt breathlessness develop.
This is why dismissing chronic tiredness as “normal” can be risky. Fatigue that is new, progressive, or associated with reduced exercise tolerance should prompt medical evaluation. Early work-up—through blood tests, cardiac imaging, stress testing, or echocardiography—can identify reversible or manageable conditions before they progress.
The message is not that every tired person has heart disease. But when fatigue persists despite adequate rest, when it limits once easy activities, or when it coexists with risk factors such as smoking, hypertension, diabetes, or a family history of heart disease, it should not be ignored.
Listening to the body early often allows timely intervention—and in cardiology, early action can significantly change outcomes. Sometimes, tiredness is simply a sign that life needs recalibration. At other times, it is the heart asking to be heard.
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