What else it might be: Blood in the stool may be due to hemorrhoids, while blood in the urine may be the result of a bladder or kidney infection. Vaginal bleeding long after menopause may be due to the growth of benign polyps or fibroids. Vomiting blood can result from a tear in the blood vessels or an ulcer in the stomach or esophagus. And coughing up blood can happen with noncancerous conditions, like bronchitis, pneumonia or tuberculosis. "There are many common reasons for seeing blood where you don't expect it, but it still has to be checked out and treated," Lichtenfeld advises.
5. High or Persistent Fever
The big worries: Fever is your body's way of fighting infection. But "fever of 103 degrees and higher warrants a trip to the doctor — period," says David Bronson, M.D., president of the American College of Physicians. It may indicate a urinary tract infection, pneumonia, endocarditis (inflammation of the lining of the heart chambers and valves) or meningitis, which may require antibiotics to clear up. A persistent low-grade fever — for several weeks — with no obvious cause is characteristic of some infections, including a sinus infection, and some cancers, like lymphoma and leukemia. "Cancer is on the list of things we think about, but it is usually not the first thing," says Ronan Factora, M.D., a geriatrician at the Cleveland Clinic in Ohio.
What else it might be: Fever can be triggered by a virus, which, depending on your health and other symptoms, may require hospitalization.
6. Shortness of Breath
The big worries: Sudden shortness of breath can indicate a pulmonary embolism — when a blood clot forms in the body's deep veins (usually in the legs), travels to the lungs and gets lodged in the lung's blood vessels. Suspect an embolism if you've recently traveled, have undergone surgery or have been immobile, and/or your shortness of breath is accompanied by chest pain and coughing up blood. If you find yourself gasping after climbing two or three stairs or getting tired sooner than you used to, doctors will want to rule out chronic obstructive pulmonary disease (COPD), especially if it's accompanied by a cough and fatigue and you have a history of smoking. Irregular heart rhythm, congestive heart failure and other types of heart disease are additional possibilities. When organs aren't getting enough oxygen, breathlessness can result. See a doctor — stat.
What else it might be: Shortness of breath can occur with asthma, bronchitis or pneumonia. You can also experience shortness of breath, sometimes with heart palpitations, if you are under extreme emotional distress or anxiety. Regardless, patients should go to the doctor. "I don't jump to a psychological issue unless there is nothing else going on," says Factora. "But we don't want to miss those few cases where survival is at stake."
7. Sudden Confusion
The big worries: If you're experiencing sudden confusion, personality changes, aggression or an inability to concentrate, it's important to see a doctor right away. "The mortality rate for severe confusion is pretty high. You have to figure out what's going on," says Bronson. In the worst case, a brain tumor or bleeding in the brain could be behind the delirium. If you're also experiencing slurred speech, difficulty finding the right words, or numbness or weakness in the face, hand or leg, stroke is a strong possibility. "You have a window of about two to three hours to get to the hospital," says Cedars-Sinai's Black. Beyond that, brain loss may be irreversible.
What else it might be: Medicines and drug-alcohol interactions can also affect your mental state. Plus, confusion can signal an infection, abnormal blood pressure, low blood sugar or dehydration, each of which should be ruled out by a physician.
8. Swelling in the Legs
The big worries: An accumulation of fluid (called edema) in the extremities can be caused by a number of conditions, but the one that most concerns doctors is heart failure, when the heart cannot pump as much blood as the body needs. When that happens, blood backs up in the veins, causing fluid to accumulate in the body's tissues. "Swelling of the legs, especially if it is persistent, should never be ignored," says Gordon F. Tomaselli, M.D., director of the division of cardiology at the Johns Hopkins University School of Medicine in Baltimore. Heart failure is suspected when both legs are affected and the patient also has shortness of breath, fatigue and chest tightness.
What else it might be: A vein problem known as venous insufficiency can also cause swelling. Normally, valves in the leg veins keep blood flowing back to the heart, but in those with venous insufficiency, these valves are weakened, causing a backup of blood. "If valves are the problem, swelling usually goes away when you lie down," Tomaselli says. Compression stockings can help. Swelling can also result from hypothyroidism (not enough thyroid hormone).
9. Sudden or severe abdominal pain
The big worries: Sudden abdominal pain could signal that an aortic aneurysm — a bulge that develops in the aorta, frequently in the abdominal area — has ruptured. "If the aneurysm ruptures, the pain tends to be sudden and severe and typically centralized around the belly button," says Richard Desi, M.D., a gastroenterologist with Mercy Medical Center in Baltimore. Alternatively, sudden pain can indicate a perforated viscus (a hole in the stomach, intestine or other hollow organ), often due to an ulcer. Intestinal ischemia, which happens when blood flow to the intestines slows or stops, starving tissues of oxygen, can be a culprit, too. "It's more common in older, sicker patients who have heart failure or atrial fibrillation," says Brian Putka, M.D., a gastroenterologist with the Cleveland Clinic. Each of these conditions is life threatening, requiring emergency surgery.
What else it might be: Abdominal pain is frequently due to gallstones, which are hard, pebblelike deposits that get lodged in a gallbladder duct, resulting in sharp pain as well as nausea and vomiting. Diverticulitis — inflammation or infection in small pouches of the large intestine — can be another cause of sudden, severe pain, along with changes in bowel habits, fever and nausea. Although irritable bowel syndrome can trigger painful spasms in the colon, the pain tends to come and go over time and may also cause constipation, diarrhea or alternating bouts of both. Appendicitis is a less likely candidate for sudden abdominal pain in those over 50, as the condition is less common with age. When it does occur, however, expect gradually worsening pain in the right-lower quadrant of the abdomen.