Do you know that even you may actually have a life threatening heart disease, if you have no heart-related complaint, or otherwise, you may not have a heart disease, even if you have a complaint?
We get the answer from Cardiologists of Hisar Intercontinental Hospital’s Cardiology Department.
When you should pay attention to a chest pain?
The underlying cause of the chest pain, one of the most important symptoms of heart disease, covers a wide range of conditions, including but not limited to a simple gas-induced ache, a life threatening myocardial infarction and perforation of the aorta – the blood vessel originating from the artery and carries the blood to the whole body. However, it is necessary to see a doctor if the pain is induced by exercise, it is felt in the form of compression on the chest, it lasts longer than 2 minutes and it disappears within 5 to 10 minutes after resting. This type of pain is felt on both sides of the chest wall, more remarkably on the left side, and it tends to radiate to arms, neck and jaw. It may seldom spread to the left scapula and shoulder. It may, sometimes, originate from the left arm and radiates to the chest or it may be felt only in the left arm. However, it is usually characterized by sudden-onset chest pain at rest during myocardial infarction. The pain is severe enough to provoke anxiety and it lasts longer than 20 minutes. It may also be associated with nausea, vomiting, cold sweat, dizziness, black-out and shortness of breath.
A part of the heart-related pains felts in the chest is related with pericardial diseases. This pain is persistent. It is aggravated by breathing and movements of chest wall. It is usually associated with fever, shortness of breath and palpitation. Aortic dissection is another cause of the chest pain originating from heart and blood vessels. In this case, the pain is extremely severe. The pain may be associated with sweating, cyanosis, low blood pressure, black-out, fainting and bruising in arms and legs. A person feels a severe pain at the central zone of the chest wall, if the pulmonary trunk and its branches are occluded by a clot. The pain is associated with cough, blood in sputum, sweating, palpitation and cyanosis.
Shortness of breath
Shortness of breath develops in response to mild exercise in people with poor fitness, sedentary lifestyle or in overweight/obese people, but also in various respiratory system diseases and anemia. The shortness of breath secondary to heart diseases is usually provoked by exercise, it disappears while resting and the patient may localize the pain by putting his hand on the chest wall, where the pain is felt. In addition, heart failures may cause shortness of breath that develops at night and wakes the patient up. It usually starts 2 to 4 hours after the patient falls asleep and the patient opens windows due to gasping for air (dyspnea). Shortness of breath may also be associated with cough. The shortness of breath gradually regresses within 15 to 30 minutes, after the patient sits down or stands up.
Palpitation implies a feeling of having too fast or pounding heart beats. Physiological range of pulse is 60 to 80 beats per minute in an adult. Tachycardia (increased heart beat), extrasystoles (extra systoles), increased cardiac output secondary to heart valve failures and sudden-onset bradycardia (too slow heartbeats) may lead to palpitation. Palpitations secondary to cardiac rhythm abnormalities are characterized by sudden-onset and sudden disappearance relative to the palpitations secondary to other etiologies such as anemia and bad temper. The palpitations that last longer than two minutes, are above 150 beats per minute, associated with dizziness, black-out or fainting are caused by rhythm disorders and they should absolutely be treated. If a person feels palpitation, the pulse should be checked by the person or a relative in order to verify whether heart rate is within normal ranges and the heart beats are rhythmic, as such data will help the physician regarding the treatment. The pulse can be easily felt on the wrist at level of the thumb.
Fainting and Fatigue
Fainting implies sudden loss of consciousness commonly secondary to reduced blood supply to the brain followed by restoration of consciousness in a short time. It may be a sign of a very severe heart disease, but it may also arise out of many other less serious etiologies. Fainting secondary to heat diseases usually develops within 1 to 2 seconds, but they do not last long. Fainting may be observed in heart valve diseases (for example, aortic stenosis – especially exertional fainting), myocardial diseases (hypertrophic cardiomyopathy), too fast and long-standing rhythm disorders, sudden slow down of the heart rate and congenital heart diseases. Fatigue and quick tiredness are among most common complaints in cardiovascular system diseases. This condition may be secondary to muscle weakness causes by systemic circulatory disorder along with the medications used for treatment of the heart disease (beta blockers, diuretic agents etc.).
The cough induced by heart diseases is usually secondary to heart failure and/or heart valve diseases. It is usually associated with wheezing, palpitation and shortness of breath. The cough is usually dry and irritating and it tends to occur at night. The cough can be associated with foamy sputum and fresh blood in sputum. The cough that wakes the patient up at night and disappears in response to standing up is a sign of heart failure.
Cyanosis purplish discoloration of skin in finger tips, lips, mucosa of mouth cavity and the tongue. It is usually recognized by relatives rather than the patient. It has two types. Central cyanosis (purplish discoloration of lips and oral mucosa) is condition that may be noted in congenital heart diseases characterized by an abnormal connection between venous and arterial circulation through a hole in the heart, resulting in poor oxygenation of the blood, while peripheral cyanosis (purplish discoloration of hands and toe tips) indicates to heart failure. If peripheral cyanosis is unilaterally observed in a limb, localized arterial occlusion is suspected.
Edema in lower limbs secondary to heart disease is symmetric and bilateral. Edema becomes remarkable when patients gain weight (3-5 kg) quickly. When the edema is pressed with finger, a dimple or a pit develops at the location. As the heart failure progresses, edema may occur in upper legs, genital organs and abdomen.
Nocturia (waking up frequently during the night to urinate) is among common symptoms of the congestive heart failure. Anorexia, abdominal distension, pain in right upper abdominal quadrant, weight loss and cachexia are among symptoms that may develop in advanced stages of the heart failure. Nausea and vomiting are frequently noted in acute myocardial infarction.