Top 10 common red flag symptoms

A red flag symptom is something abnormal about your body or mind, that may indicate something is significantly wrong. ‘Red flag’ means potentially serious (and potentially treatable). All mean you should see a doctor – in some cases .. today.

So. What is a red flag symptom? There are two types:

Top 10 common acute red flag symptoms

Acute symptoms = a rapid onset of symptoms that have started recently (last 24 hours), and you feel may be serious. Below are some examples of acute red flag symptoms, and what they could indicate:

1. Severe chest pain – heart attack, aortic dissection, pulmonary embolus (clot in lungs), collapsed lung
2. Severe headache – bleed in brain (e.g. subarachnoid haemorrhage), meningitis (a brain infection), head injury
3. Shortness of breath – heart failure, or COPD/asthma
4. Weakness on one side (or speech disturbance) – stroke
5. High fever or feeling very cold (especially with rash) – infection (sepsis, including meningitis)

Other acute red flag symptoms

1. ‘3Cs’ – reduced Consciousness, Collapse or Confusion (new) – many causes including infection (sepsis), side effects of medication, recreational drugs/alcohol (excess or withdrawal), low blood pressure
2. Uncontrolled heavy bleeding (e.g. vomiting, in poo, in wee, or out of vagina) – many causes
3. Loss of eyesight or severe eye pain – many causes including bleed, blod clot, glaucoma, uveitis, giant cell arteritis
4. Severe abdominal pain – appendicitis, ectopic pregnancy, bowel obstruction, AAA, renal colic
5. Possible fracture – any part of arm and leg, pelvis.

If you have any of these symptoms, do not go to your GP. Go to your nearest A&E. If you are too unwell to do that, dial 999 and request an ambulance. You need to get there ideally in less than 2 hours. We are here to help you.

Top 10 common chronic red flag symptoms

Chronic symptoms = a slower onset of symptoms that occurs over a few weeks, and you feel may be serious. Below are some examples of chronic red flag symptoms, and what they could indicate:

1. Blood in urine (wee) – bladder or kidney cancer
2. Blood in faeces (poo) – bowel cancer
3. Vaginal bleeding in a woman whose periods have stopped – uterine (womb) or cervical cancer
4. New severe back pain or inability to walk, loss of control of bowels or bladder – spinal cord compression
   Note. This is really a subacute problem, as it may need surgery soon (today/tomorrow)
5. Blood in sputum (spit) – lung cancer.

Other chronic red flag symptoms

1. Swollen ankles or shortness of breath – heart or kidney failure
2. Unexplained weight loss, abdominal or bone pain – cancer
3. A lump in your breast, or change in the nipple – breast cancer
4. Unexplained or changing lump(s) or mole anywhere in body – skin cancer
5. Unexplained deteriorating health or function – with failure to respond to treatment.

If you have any of these, please see your NHS GP soon (ideally the next two-to-three days) and ask to be seen face-to-face and examined. You may need to ask for a ‘double appointment‘ (20 mins).
Note. Possible spinal cord compression needs to be seen by your GP today. If this is not possible, go to A&E.

If the doctor agrees that it is a red flag symptom, and suspects that it could be cancer, you should be referred to a local hospital via the two week cancer wait (2WW) system (in England). You should then see a consultant within two weeks of referral. They may send you for tests before the appointment.

If the problem is not thought to be due to cancer, but is still serious (e.g. heart or kidney failure), the GP should ring a specialist at the local hospital, and arrange for you to be seen very soon (less than two weeks). They may have a ‘hot clinic’ where you can be seen soon.

Summary

We have described our top 10 common red flag symptoms (acute and chronic). All mean you should see a doctor. We hope it has been helpful.