Across the globe, cardiovascular disease is the leading cause of death, responsible for nearly 18 million fatalities annually. This includes conditions that affect the heart and circulatory system such as strokes, coronary heart disease and heart failure.

And in the UK it is just as deadly, causing around a quarter of all deaths. Therefore, spotting the warning signs before it is too late could be life saving.

Many of us are aware of some of the most common symptoms, such as chest pain. However, others are lesser known and less obvious.

In some cases these symptoms can appear in the most unlikely of places – including the feet.

According to the American Academy of Dermatology (AAD) there are three red flag signs of cardiovascular problems to spot on the feet and toes.

These include:

• Swelling in your feet
• Blue toes
• Painful lumps on the toes.

Swelling in your feet

Swollen feet, as well as legs and ankles, is one symptom of heart disease.

Known medically as oedema, it can be an indication that “your heart isn’t working properly”.

The AAD explains: “Many diseases of the heart cause fluid to build up in your feet and lower legs.

“As the fluid builds up, you may see swelling, which can extend as far as the upper legs and groin.”

The NHS states that this swelling may be “better in the morning and get worse later in the day”.

Blue toes

This could be a sign that you have a blockage in a blood vessel.

“When you’re extremely cold, your skin can turn blue (or purple)” the AAD says.

“If an area of your skin is blue (or purple) when you’re warm, that can be a sign your blood isn’t getting enough oxygen.

“The patient in this photo has a condition known as blue toe syndrome, which happens when one or more blood vessels are blocked.

“Without treatment, the lack of oxygen can cause the skin and underlying tissue to eventually die.”

The medical term for this phenomenon is cyanosis.

Painful lumps on the toes

These lumps on your toes are called Osler nodes and can also affect the fingers.

The AAD says: “If you have a heart infection known as infective endocarditis, these painful lumps can develop in your fingers, toes, or both places.

“The lumps can last for a few hours to several days.

“While the lumps go away on their own, patients need treatment for the infection.

“Because this infection is caused by bacteria, antibiotics can often treat it. Sometimes, surgery is also necessary.”