OVERVIEW
Cardiovascular diseases give rise to a relatively limited range of different symptoms. However, to rule out the correct diagnosis of heart disease, there needs careful analysis of the factors that promote the heart symptoms, the subtitle differences, and how the patient describes the heart symptoms.
There is a close relationship between heart disease symptoms and exercise is the Hallmark of all heart diseases. There are a variety of heart disease symptoms and the symptoms depend upon which disease the patient is presenting with. The main symptoms include chest pain. The chest pain is usually marked on exertion, syncope or loss of consciousness, breathlessness, palpitations, and severe prolonged chest pain.
MOST COMMON HEART DISEASE SYMPTOMS
- Chest pain on physical work: heart disease patient complaints of chest pain on physical work. This chest pain may be due to other causes as well. But the chest pain of heart diseases is typically crushing or constructing in nature and it radiates to left shoulder and jaw. It is Central and diffuse has a gradual onset and takes Several minutes to develop. It is less than 30 minutes in angina pectoris and is relieved by rest in angina, but not so in myocardial infarction. The full history of the patient is crucial in determining whether chest pain is a heart disease symptom or due to some other cause.
- Severe prolonged pain in the chest: the patient complains of severe prolonged chest pain. The prolonged chest pain may be due to acute coronary syndrome, unstable angina, or myocardial infarction. It is the main presenting feature of the acute coronary syndrome. Patients with prolonged chest pain will have a previous history of stable angina. Chest pain at exertion is the initial symptom which the patient complaints which later progress to chest pain at rest. Admit the patient to the hospital immediately when he suffers prolonged chest pain.
- Loss of consciousness: As the blood flow to the brain is reduced in heart diseases, the patient suffers from loss of consciousness. This term is also called as ‘syncope’. It is due to decreased cerebral perfusion and as a result, the patient becomes unconscious.
- Breathlessness: cardiac causes of breathlessness include acute coronary syndrome, valvular heart diseases, pericarditis, cardiomyopathy or acute and chronic heart failure. Breathlessness can be due to other noncardiac causes so it should be investigated properly to rule out the cause and for properly treating the patient.
- Palpitations: palpitation is a common symptom of heart diseases. it is due to a disorder of Cardiac Rhythm. Palpitations mean the feeling of one’s own pulse. It is an unusual sensation and sometimes can Trigger anxiety in patients, it is usually due to a forceful heartbeat. Palpitations can occur in other diseases as well for example hyperthyroidism, anxiety, or fever but it is one of the common symptoms of heart diseases.
STABLE ANGINA PECTORIS:
Substernal chest pain of 5 to 20 minutes duration occurs in stable angina. It Refers to chest pain due to myocardial ischemia and is due to fixed stenosis of arteries. The pain of stable angina is relieved by rest or nitrates and is increased by physical exertion, cold exposure, emotional Trigger, heavy meals. The pain is the main heart disease symptoms and radiates to the left arm, jaw, and neck and is associated with nausea, vomiting, sweating, and head lightness…
ACUTE CORONARY SYNDROME (ACS):
The acute coronary syndrome is a term which is referred to describe
- unstable angina
- Non-ST-elevation myocardial infarction (NSTEMI)
- ST-elevation myocardial infarction (STEMI)
The acute coronary syndrome occurs due to plaque formation in the arteries which causes narrowing of arteries and superimposed thrombus formation. The mechanical feature of the acute coronary syndrome is chest pain which is retrosternal in nature and radiates to arms, neck, and jaw. The pain is associated with vomiting, loss of consciousness, and difficulty in breathing. The pain is more severe and lasts more than 30 minutes as compared to angina pectoris whose pain lasts only 10 to 15 minutes. The pain is constructing or compressing and it is not relieved by nitrates or rest.
Heart Disease Symptoms of Congestive Cardiac Failure
Congestive cardiac failure is the condition in which the heart is not able to pump the blood required to meet the oxygen demand of tissues and organs. Left heart failure is the most common type of heart failure and it occurs because the heart cannot eject blood into tissues and organs. Chest pain is the main heart disease symptoms for congestive cardiac failure.
Dyspnea or difficulty in breathing and orthopnea. Orthopnea means difficulty in breathing when the patient lies flat and it is released by elevation of the head, by placing pillows under the head. Paroxysmal nocturnal dyspnea refers to the sudden attack of extreme difficulty in breathing which occurs at night and the patient wakes up from sleep and suffers anxiety and suffocation. It is relieved by sitting up and putting pillows under the neck. Right heart failure Is characterized by liver enlargement and edema which is usually generalized and venous distention.
ATRIAL FIBRILLATION:
Atrial fibrillation is one of the most common sustained Cardiac arrhythmia cardiac. Arrhythmia means the heart is not able to maintain its normal sinus rhythm. Multiple foci are created within the Atria that fire continuously in a haphazard manner and it causes irregular pulse within and the patient suffers palpitations. If you check the pulse, the pulse is irregularly irregular in nature. The cause of atrial fibrillation includes pulmonary embolism, thyrotoxicosis, sepsis, rheumatic heart disease, and ischemic heart disease including MI. A proper investigation and history of the patient are required to label the atrial fibrillation as a cause of heart disease.
PULMONARY EDEMA:
It is the worst and most serious complication of congestive cardiac failure. It occurs when the hydrostatic pressure is increased as compared to pulmonary pressure. The main symptom of pulmonary edema are sudden onset of shortness of breath, increased rate of breathing, Sounds while taking breath and decrease in oxygen saturation of less than 90%.
MITRAL STENOSIS:
Stenosis is a condition that is characterized by the narrowing of the mitral valve orifice. The narrowing leads to decrease ejection of blood into the left ventricle and as a result, there is hypertrophy of left Atrium and it is dilated. The most dominant symptom of mitral stenosis is difficulty in breathing on exertion. The patient suffers from chronic fatigue due to a decrease in cardiac output. There is left atrial enlargement and as a result, this area presses on esophageal and the patient suffers dysphagia or difficulty in eating. There is hoarseness of voice as the enlarged left Atrium press on the recurrent laryngeal nerve. The patient suffers palpitations due to atrial fibrillation as the left Atrium is dilated, muscular walls stretch which initiates the pacemaker and it causes atrial fibrillation.
MITRAL REGURGITATION:
Mitral regurgitation means the mitral valve is destroyed and it does not fit together and there is the retrograde flow of blood in the left atrium during systole. The most common cause of mitral regurgitation is rheumatic fever. The patient presents with pulmonary edema, hoarseness of voice, hypertension, or low blood pressure in acute cases. When mitral regurgitation is chronic, it leads to gradual enlargement of left Atrium and as a result, the patient remains asymptomatic for many years and then presents with sudden left heart failure and death.
MITRAL VALVE PROLAPSE:
Mitral valve prolapse is due to degeneration of the mitral valve and it is a condition is characterized by backward flow of blood into the left atrium during systole due to bulging of anterior and posterior leaves of the mitral valve. The patient presents typically with chest pain which is atypical in nature. It is the most common symptom of mitral valve prolapse. The patient also suffers from palpitations or feeling of one’s pulse and panic attacks
AORTIC STENOSIS:
Aortic stenosis is the most common heart disease and it is characterized by stenosis of the aortic valve. As a result, there is a blockage of the outflow of blood. The blood is not able to pass from left Atrium to the left ventricle and as a result, it results in left ventricular hypertrophy. The most common cause for aortic stenosis is calcification of aortic valve or congenital bicuspid aortic valve. Aortic stenosis presents with chest pain and it is the most common heart disease symptom of aortic stenosis. Chest pain has a gradual onset and Rises slowly. It is substernal in nature and occurs for more than 30 minutes. the pain radiates to neck and Shoulder and is constricting or compressing in nature. It is followed by a loss of consciousness. It may also present a sudden cardiac death.
AORTIC REGURGITATION:
Aortic regurgitation is a condition that is characterized by the backward flow of blood into the left ventricle due to the incompetence of the aortic valve. The Cause of aortic regurgitation is not competent or are dilated valves and as a result, there is the retrograde flow of blood into the left ventricle during systole. A most common infectious cause for aortic regurgitation is infective endocarditis. When aortic regurgitation presents acutely, there is a symptom of hypertension, Pulmonary edema, and carcinogenic shock. When the disease is chronic in nature, the patient remains asymptomatic for many years until left ventricular failure develops and then congestive cardiac failure occurs. It may also result in sudden cardiac death.
TRICUSPID VALVULAR DISEASE:
Tricuspid stenosis has the main clinical feature of raised jugular venous pressure. The patient suffers murmurs which are best heard at the left sternal border of the heart. The tricuspid regurgitation occurs due to incompetent heart valves. The main clinical feature is raised JVP and the patient exhibits pansystolic Murmur which is best heard at the left sternal border.
HYPERTROPHIC CARDIOMYOPATHY (HCM):
hypertrophic cardiomyopathy is the group of conditions that are inherited and it is associated with hypertrophy od myocardium. It is the most common cardiomyopathy. And the most common cause is a mutation in sarcomere genes. The heart disease symptoms for hypertrophic cardiomyopathy include difficulty in breathing on exertion, exertional chest pain, arrhythmias, syncope or loss of consciousness, palpitations, sudden cardiac death. Sudden cardiac death is the most common presenting symptom in young athletes. One of the signs for dilated cardiomyopathy is murmurs. Ejection systolic Murmur is heard at the left lower sternal border and it occurs due to left ventricular outflow obstruction. There is also a pansystolic murmur which is best heard at the apex and it occurs due to mitral regurgitation as valves are rendered incompetent due to the dilation of the myocardium.
HEART DISEASE SYMPTOMS OF PERICARDITIS:
Pericarditis means inflammation of the pericardium. The most prominent symptom is chest pain which radiates to neck, jaw, and arm and the patient has positional Sitting as the pain increases by lying straight, coughing. The patient is seen sitting up and leaning forward. This is referred to as the position of sitting of the patient. The heart sounds are faint and the apex beat is not localized. However, the pulse is regular.
PERICARDIAL EFFUSION AND CARDIAC TEMPONADE:
Effusion means a collection of fluid within the space of pericardial sac and cardiac tamponade means compression of the heart by the development of pericardial effusion and it results in acute heart failure. The main symptom of pericardial effusion and cardiac tamponade is hypertension, distant heart sounds, raised JVP and pulses paradoxical which refers to a decrease in systolic blood pressure of more than 10mmHg during inspiration. as pericardial effusion becomes worse the symptoms of cardiac tamponade are more evident.
AORTIC DISSECTION:
Aortic dissection is characterized by tearing of the inner wall of aorta which is called Intima and it results in an excavation of blood into the tunica media, which is the middle layer of the aorta. The wall is split into two layers which causes the space between two layers and it is referred to as aortic dissection. The main heart disease symptoms for aortic dissection is the asymmetry of pulses, hypertension, increased risk of cerebrovascular accidents, congestive cardiac failure, loss of consciousness, hypotension, and shock.
CONCLUSION:
Of all the cardiovascular events, the main heart disease symptoms are chest pain, difficulty in breathing, loss of consciousness, palpitations or sudden cardiac death. You should seek medical help as soon as you suffer any of the above mentioned heart symptoms so that your doctor may investigate you for the cause which will lead to the proper treatment of your heart disease.