Houston, We Have a Heart Problem

For millions of people, having a regular 9-to-5 schedule is a luxury. Police officers, nurses, pipeliners, and emergency responders who work night shifts, rotating shifts, or extended hours face unique health challenges. Beyond the struggle of staying awake, shift work has been scientifically linked to a higher risk of cardiovascular disease.

Circadian rhythm disruptions, along with fatigue and stress throws essential bodily processes – like blood pressure, metabolism, and inflammation – into disarray. February is heart health month in both the United States and Canada, so there’s no better time to reflect on this topic, especially as it pertains to shift workers!

Heart issues often present with less dramatic, more ambiguous symptoms and signs than just crushing chest pain. Experts at Harvard Health highlight several surprising cues that may signal heart trouble[1]:

1. Unusual Fatigue or Breathlessness – While constant fatigue can feel normal, if you experience extreme, unexplained exhaustion that makes routine tasks, like climbing a short flight of stairs or walking across a parking lot difficult, it could be a warning sign. When the heart can’t pump effectively, less oxygenated blood reaches your muscles, leading to fatigue and shortness of breath during everyday activities. This is a symptom that warrants medical attention, especially if you experience a sudden or significant change in energy levels.
2. Nausea, Indigestion, or Bloating – Stomach discomfort may be blamed on irregular mealtimes or poor food choices. But, nausea, indigestion, or bloating can be critical, overlooked symptoms, particularly in women. Digestive issues are sometimes present during a heart attack, even before chest pain begins. If you experience these symptoms alongside cold sweats or discomfort in your upper body, do not dismiss them as simple heartburn.
3. Pain in the Neck or Jaw – While chest pain is common, Johns Hopkins Medicine experts stress that chest pain doesn’t always center on the heart and that pain radiating to the jaw and neck is a significant concern[2]. This type of pain may feel like aching, pressure, or tightness, rather than sharp pain.
4. Sleep Apnea – Sleep apnea can be a significant indicator of underlying vascular issues. This disorder, characterized by pauses in breathing during sleep, has been linked to high blood pressure and an increased risk of heart attack. For shiftworkers already struggling to achieve quality sleep, recognizing and treating sleep apnea is essential for cardiovascular protection.

Managing heart health as a shiftworker requires proactive heart health strategies:

• Prioritize Sleep Consistency: Aim to get 7 to 9 hours of sleep, even if it is during the day. Use blackout curtains and earplugs to create a dark, quiet, cool sleeping environment. Try to stick to the same sleep and wake times as much as possible, even on days off.
• Plan for Healthy Eating: Pack heart-healthy meals that are high in fiber and low in sodium. Avoid heavy, high-fat meals just before sleeping.
• Get the Body Moving: Incorporate exercise when possible. Even short bursts of activity, like a 10-minute walk before and after your shift, can help manage weight, blood pressure, and cholesterol.
• Regular Check-ups: Talk with your doctor about the challenges you face regarding shiftwork. Regular check-ups for blood pressure, cholesterol, and blood sugar are critical for shiftworkers.

If you experience any persistent, unusual, or worsening symptoms, it is critical to seek medical attention immediately. Do not assume your symptoms are just the consequence of a difficult schedule. You are trained to notice warning signs on the pipeline, and to catch issues before they become a disaster. Apply that same vigilance to your own body – don’t let the fatigue of shiftwork mask a critical alarm from the heart!

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[1] 5 overlooked symptoms that may signal heart trouble, Harvard Health Publishing, Havard Medical School, https://www.health.harvard.edu/heart-health/5-overlooked-symptoms-that-may-signal-heart-trouble, August 8, 2023.

[2] Surprising Body Cues That Could Be a Heart Concern, Johns Hopkins Medicine, https://www.hopkinsmedicine.org/health/wellness-and-prevention/surprising-body-cues-that-could-be-a-heart-concern, last accessed November 20, 2025.