Thanks to Instagram and other such social media platforms, we know a lot about our health than before. In a video, a person presses on his lower leg, and instead of the skin bouncing back smoothly, it shows small pit-like impressions. The caption on the video reads: A Visible Sign Of Congestive Heart Failure.

A throbbing dorsalis pedis pulse, the artery running along the top of the foot, might appear harmless at first glance. However, doctors caution that such a finding can be an important clinical sign, often linked to conditions such as peripheral vascular changes or fluid overload. In particular, it may reflect elevated central venous pressure (CVP), a common feature of congestive heart failure (CHF).

Medical experts recommend that whenever this sign is seen, it should not be dismissed. Instead, patients should be assessed thoroughly, including checking bilateral pulses, looking for swelling in the legs or feet, and correlating these observations with blood pressure and a full cardiac examination.

Understanding Congestive Heart Failure

Congestive heart failure, also called simply heart failure, is a long-term condition where the heart cannot pump blood efficiently enough to meet the body’s needs. While the heart is still beating, it struggles to keep up with circulation demands. As a result, blood builds up in other parts of the body, most often in the lungs, legs, and feet.

Doctors often describe it with a relatable analogy: imagine a shipping department that is constantly behind schedule. Packages pile up because they cannot be dispatched on time. Similarly, in heart failure, fluid “packages” accumulate in the body, leading to symptoms and complications.

Different Types of Heart Failure

Heart failure is not a one-size-fits-all condition. It has different forms:

• Left-sided heart failure, where the left ventricle struggles to pump blood effectively.
• Right-sided heart failure, which often results from long-standing left-sided failure and leads to blood backing up in veins.
• High-output heart failure, a rare type where the heart pumps normally but the body demands more blood than it can provide.
• Right-sided heart failure is particularly linked to distended veins and visible pulsations, as seen in cases where fluid overload is present.

How Widespread Is the Problem?

Heart failure is alarmingly common. In the United States alone, more than six million people live with the condition, making it the leading cause of hospitalization among those older than 65. With aging populations and rising lifestyle-related diseases such as diabetes and hypertension, the burden of CHF is expected to grow further.

Common Symptoms Of Heart Failure

CHF can manifest in many ways, some subtle and others unmistakable. Typical symptoms include:

• Shortness of breath, especially during activity or at night
• Chest pain and palpitations
• Fatigue and weakness
• Swelling in the ankles, legs, and abdomen
• Weight gain and frequent nighttime urination
• A persistent, dry cough or bloating in the stomach

Some patients may experience only mild discomfort, while others face severe, life-limiting symptoms. Importantly, the condition tends to worsen over time if not managed.

Causes and Risk Factors

Several factors contribute to the development of heart failure, including:

• Coronary artery disease and heart attacks
• Long-standing high blood pressure
• Cardiomyopathy, often due to genetics or viral infections
• Diabetes and kidney disease
• Obesity, tobacco use, alcohol, or recreational drug use
• Certain medications, such as chemotherapy drugs

Risk increases with age, sedentary lifestyle, poor diet, and family history of heart disease. Left-sided heart failure is the most common trigger for right-sided failure, but lung diseases and other organ issues can also play a role.

Potential Complications

Unchecked heart failure can lead to serious complications such as irregular heart rhythms, sudden cardiac arrest, valve damage, fluid buildup in the lungs, kidney or liver failure, and malnutrition. These risks make early recognition of clinical signs, such as visible dorsalis pedis pulsation, critically important.

Diagnosing Heart Failure

Doctors use a combination of medical history, physical examinations, and diagnostic tests to confirm CHF. They typically ask about family history, lifestyle habits, medication use, and other medical conditions. Key tests include echocardiograms, ECGs, chest X-rays, MRIs, CT scans, stress tests, and blood work. In some cases, genetic testing may also be used.

Stages of Heart Failure

Heart failure is classified into four stages (A to D):

Stage A: High risk but no symptoms, often due to conditions like hypertension or diabetes.

Stage B: Structural heart problems but no outward symptoms.

Stage C: Clear symptoms alongside a confirmed diagnosis.

Stage D: Advanced heart failure with severe, treatment-resistant symptoms.

While your mouth and heart may seem unrelated, medical science shows otherwise. There’s a deeper connection between oral and cardiovascular health than most people realize. Certain dental symptoms can act as early warning signs for heart-related issues. To better understand this link, we spoke with Dr. SS Sibia, Cardiologist and Director at Sibia Medical Centre, Ludhiana.

When people think of heart disease, they typically focus on chest pain, breathlessness, or fatigue. But some of the earliest red flags can appear inside the mouth. Several oral health issues are directly linked to cardiovascular conditions. Research has long shown a connection between gum health and heart disease, and ignoring these subtle clues could lead to serious consequences.

6 Mouth Symptoms That May Be Warning Signs of Heart Disease

Here are six mouth symptoms that might point to an underlying heart condition:

1. Red, Swollen, or Bleeding Gums

Inflamed or bleeding gums often indicate gum disease (periodontitis), a bacterial infection of the tissues surrounding the teeth. Studies show that the bacteria responsible can enter the bloodstream, causing inflammation in blood vessels and contributing to artery blockages—a major factor in heart attacks.

Dr. Sibia explains: “Gum disease doesn’t just affect your mouth. It significantly raises the risk of cardiovascular complications. Persistent gum bleeding is a signal to visit both a dentist and a heart specialist.”

2. Wobbly Teeth or Tooth Loss

Losing teeth, particularly due to advanced gum disease, isn’t only about poor dental hygiene. It often reflects chronic inflammation in the body, which can increase the risk of heart attacks and strokes. Studies suggest people with fewer teeth due to gum infections are more likely to develop serious heart problems.

3. Persistent Bad Breath

Ongoing bad breath (halitosis) may be more than just a dental concern. It can result from bacteria linked to gum disease, which is strongly connected to heart health. Bad breath may also indicate inflammation or internal infection, both of which place additional strain on the heart if untreated.

4. Mouth Sores or Infections That Don’t Heal

Frequent oral ulcers or infections that take unusually long to heal could point to poor blood circulation or a weakened immune system. These issues are commonly seen in heart patients or people with diabetes, who are already at higher risk for cardiovascular disease.

5. Dry Mouth

A dry mouth (xerostomia) may be a side effect of medications for heart disease or high blood pressure. In some cases, it could signal dehydration, diabetes, or reduced blood flow, all of which can strain the heart. Dryness also makes the mouth more vulnerable to infections, indirectly affecting heart health.

6. Jaw Pain

Discomfort in the jaw, especially the lower jaw, can sometimes indicate an impending heart attack, particularly in women. This pain may radiate from the chest or neck and is often mistaken for a dental problem. If jaw pain comes with breathlessness, sweating, or chest tightness, seek medical help immediately.

Dr. Sibia warns: “Heart attacks don’t always start with chest pain. For some, especially women, symptoms like jaw pain or mouth discomfort may be the first signs. Detecting them early can be life-saving.”

Heart Disease: Mouth Symptoms

Regular dental visits, good oral hygiene, and attention to unusual changes can help detect potential heart issues early.

If you notice any of the signs above, don’t ignore them. Consult both a dentist and a cardiologist to ensure you’re not missing something serious. Timely check-ups, preventive care, and small lifestyle changes can significantly reduce your risk of heart disease.

We all know influenza is a common and sometimes serious viral infection, but it’s worth a reminder as the flu season approaches, typically starting in October. Between October 2024 and May 2025, the United States saw an estimated 47 million to 82 million flu cases, leading to 610,000 to 1.3 million hospitalizations, according to preliminary data from the US Centers for Disease Control and Prevention. While most flu-related deaths occur in older adults, children can also be affected, with CDC estimates showing 37 to 199 deaths among children each flu season.

Now, a new study published in JAMA has highlighted a rare yet severe complication that can affect children who contract the flu. Known as acute necrotizing encephalopathy (ANE), this condition carries a mortality rate of 27% even with intensive medical care, according to the research.

What Is Acute Necrotizing Encephalopathy?

Acute necrotizing encephalopathy (ANE) is a rare but serious brain disorder that can develop after a viral infection, most commonly influenza. It begins with a fever and quickly progresses to severe neurological problems, such as seizures and a reduced level of consciousness. Importantly, the condition is caused by the body’s inflammatory immune response to the virus, rather than the virus directly attacking the brain.

Treatment typically involves supportive care and, in some cases, immunosuppressive therapies, but outcomes are often poor, with high rates of death and long-term brain damage.

Symptoms of Acute Necrotizing Encephalopathy

ANE usually starts with symptoms of the initial viral infection, such as fever, cough, vomiting, and diarrhea, followed by rapid neurological decline, which may include:

• Seizures
• Confusion, drowsiness, and altered consciousness
• Coma lasting for weeks
• Problems with movement (ataxia)
• Abnormal muscle tone

How Can Flu Lead to Acute Necrotizing Encephalopathy?

According to the National Institutes of Health, the flu can trigger ANE through an overactive inflammatory response. In this scenario, the body’s immune system, activated by the virus, ends up damaging brain tissue rather than the virus directly affecting the brain. This process, often called a cytokine storm, leads to rapid swelling, inflammation, and tissue death in areas such as the thalamus, resulting in severe neurological symptoms like seizures and coma. Genetic factors may also make some children more vulnerable.

The researchers collected data from US pediatric hospitals and public health agencies on cases of pediatric ANE treated between October 2023 and May 2025. They analyzed 41 children with influenza-related ANE. The median age was 5, and roughly three-quarters were previously healthy. Among those whose vaccination history was known, only 16% had received the flu vaccine that season.

All of these children became seriously ill, and every patient developed encephalopathy, meaning altered brain function. Sixty-eight percent experienced seizures, and most had abnormal platelet counts, liver enzyme levels, and spinal fluid composition.

The researchers emphasized a few key points:

• ANE is rare but extremely serious, with high risks of long-term illness or death, making early diagnosis and treatment critical.
• Most children affected were previously healthy.
• While a few vaccinated children also became ill, most cases and nearly all fatalities occurred in children who were not vaccinated that season.

Why the Flu Vaccine Matters

What is clear from this research is that getting the flu vaccine lowers the chance of catching the virus and of becoming seriously ill. The JAMA study also indicates that vaccination reduces the likelihood of developing ANE and the risk of dying from it. Both the study and an accompanying editorial stress the importance of everyone staying up-to-date with their flu shots.

As the winter season sets in, the US Centers for Disease Control and Prevention (CDC) expects the 2025–26 fall and winter respiratory virus season to bring roughly the same number of hospitalizations linked to Covid-19, flu, and RSV as last year. Still, there are ways to lower your risk of becoming seriously ill from these infections, and vaccination remains one of the most effective measures.

According to preliminary CDC data from October 2024 through May 2025, around 1 million people were hospitalized with the flu last season, and there were as many as 130,000 flu-related deaths. Between October 2024 and September 2025, CDC estimates also show nearly 540,000 Covid-19 hospitalizations and up to 63,000 deaths due to the virus.

As the season of respiratory illness is here, let’s take a look at some common vaccine questions.

Who Can Get Covid Shots?

The CDC recommends that everyone aged 6 months and older, including pregnant individuals, discuss getting the updated Covid-19 vaccine with their health care provider this season. This marks a shift from earlier years, when the guidance broadly encouraged most people to get vaccinated.

“This fall, the CDC hasn’t issued a universal recommendation for the Covid-19 vaccine,” explained Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center. “Instead, it’s being offered under a shared-decision model, where people are encouraged to talk to their doctor about the risks and benefits before deciding.”

When Is The Best Time To Get The Covid Vaccine?

Dr. Sarah Dupont, a family medicine physician at Emory Healthcare and assistant professor at Emory University School of Medicine, suggests getting the Covid-19 vaccine in October or early November for the best protection through winter.

How Effective Is The Covid Vaccine?

A recent study published in the New England Journal of Medicine found that last year’s updated Covid-19 vaccines were about 39% effective in preventing hospitalizations and 64% effective in preventing deaths among US veterans.

Who Can Get A Flu Shot This Year?

The CDC advises that most people aged 6 months and older should get a flu shot every year. Generally, one dose is sufficient each season. However, children receiving the flu vaccine for the first time should get two doses, spaced about four weeks apart, to build stronger immunity.

How Effective Is The Flu Shot?

The effectiveness of this year’s flu vaccine won’t be known until after the season ends. For reference, during the 2024–25 respiratory virus season, the CDC estimated that flu vaccines were 42% to 56% effective in adults.

Who Can Get An RSV Immunization?

RSV vaccines are recommended for adults aged 75 and older, and for those aged 50 to 74 who face a higher risk of severe illness, according to the CDC. A single dose can offer protection for at least two years in older adults.

To safeguard infants, protection can come either from maternal vaccination during pregnancy or from an antibody shot administered to the baby after birth.

When Is The RSV Vaccine Available?

Eligible adults can get the RSV vaccine at any point, though the CDC notes that late summer to early fall is ideal. For mothers, the vaccine is typically available from September through January, while infants can receive their antibody shot from October through March.

Beyond vaccination, there are other ways to stay healthy this season. Health experts urge people to stay home when they feel unwell to prevent spreading illness. Those who want to be extra cautious can avoid crowded indoor spaces during winter, and wearing a mask remains a personal option for reducing both your own risk and that of others.