Cardiac-related symptoms may occur even in older adults without a diagnosed heart condition, raising questions about early detection of cardiovascular disease (CVD). Cross-sectional baseline data from the NORwegian atrial fibrillation self-SCREENing (NORSCREEN) trial published in the European Heart Journal Open evaluated self-reported cardiac-related symptoms and quality of life (QoL) among adults aged ≥65 years with increased stroke risk (CHA2DS2-VA ≥2). All participants completed questionnaires capturing clinical characteristics, symptoms, and RAND-36 QoL measures. 

Between 2023 and 2025, 50,549 individuals were enrolled; 39,281 (78%) reported no diagnosed cardiac disease and constituted the primary analysis group. Among these individuals, 17,069 (43%) reported cardiac-related symptoms. 

The most common symptoms were fatigue, exertional dyspnea, and tachycardia. Symptom reporting was associated with female sex [adjusted odds ratio (aOR) 1.66, 95% confidence interval (CI) 1.58-1.75], physical inactivity (1.43, 1.32-1.55), current smoking (1.24, 1.12-1.37), age <75 years (1.14, 1.08-1.20), living alone (1.13, 1.07-1.20), chronic obstructive pulmonary disease (COPD) (6.51, 5.63-7.54), and anxiety (3.99, 3.64-4.38). Participants with symptoms reported significantly lower RAND-36 QoL scores across all domains than those without symptoms. 

Nearly half of adults at higher stroke risk without diagnosed cardiac disease reported symptoms. These findings suggest potential unmet needs in identifying and managing CVD.